Individual provider Active NPI

Mary C Osunwa

  • Medical-Surgical Registered Nurse
  • Baltimore, MD
National Provider Identifier
1568002103
Registry record updated Jan 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
R167333 Issued in MD
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

Updated by the provider on Jan 12, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
R167333MDMDMedical-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.

Verify at the official NPI Registry.