Active NPI
Risikat Oluwakemi Dawodu, NP
- Nurse Practitioner
- Upper Marlboro, MD
National Provider Identifier
1588359111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R205998
- Practice address
- 15605 Tibberton Ter
Upper Marlboro, MD 20774-9092 - Phone
- (144) 396-8585
- NPI assigned
- Apr 10, 2023
- Last updated
- Apr 10, 2023
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R205998 | MD | Primary |
Addresses
Primary practice location
15605 Tibberton Ter
Upper Marlboro, MD 20774-9092
Mailing address
15605 Tibberton Ter
Upper Marlboro, MD 20774-9092
Phone (144) 396-8585
Other names 1
- Ms. Risikat Oluwakemi Dawodu
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R205998 | MD | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681084800000",
"number": "1588359111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15605 TIBBERTON TER",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207749092",
"telephone_number": "144-396-8585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15605 TIBBERTON TER",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207749092",
"telephone_number": "144-396-8585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWODU",
"first_name": "RISIKAT",
"middle_name": "OLUWAKEMI",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-10",
"last_updated": "2023-04-10",
"certification_date": "2023-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MD",
"license": "R205998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RISIKAT",
"last_name": "DAWODU",
"middle_name": "OLUWAKEMI",
"prefix": "MS.",
"credential": "NP",
"code": "2",
"type": "Professional Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.