Active NPI
Mary C Osunwa
- Medical-Surgical Registered Nurse
- Baltimore, MD
National Provider Identifier
1568002103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- R167333
- Practice address
- 2713 Latona Rd
Baltimore, MD 21214-2114 - Phone
- (443) 655-0307
- NPI assigned
- Jan 12, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | R167333 | MD | Primary |
Addresses
Primary practice location
2713 Latona Rd
Baltimore, MD 21214-2114
Mailing address
9305 Beowulf Cir
Baltimore, MD 21237-4515
Phone (240) 437-8393
Other practice location 1
6121 Fairwood Ave
Baltimore, MD 21206-2405
Phone (443) 655-0307
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R167333 | MD | MD | Medical-Surgical Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578787200000",
"number": "1568002103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9305 BEOWULF CIR",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212374515",
"telephone_number": "240-437-8393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2713 LATONA RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212142114",
"telephone_number": "443-655-0307"
}
],
"practiceLocations": [
{
"address_1": "6121 Fairwood Ave",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212062405",
"country_code": "US",
"telephone_number": "443-655-0307",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OSUNWA",
"first_name": "MARY",
"middle_name": "C",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-12",
"last_updated": "2020-01-12",
"certification_date": "2020-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "MD",
"license": "R167333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.