Individual provider Active NPI

Mary Oluwatoyin Taiwo, NP

  • Family Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1639662489
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024175935 Issued in VA
Practice address
2000 Angler CT
Chesapeake, VA 23323-5345
Phone
(443) 956-3961
NPI assigned
Jun 7, 2018
Last updated
Jun 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024175935 VA Primary

Addresses

Primary practice location

2000 Angler CT
Chesapeake, VA 23323-5345

Mailing address

2000 Angler CT
Chesapeake, VA 23323-5345
Phone (443) 956-3961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210511000407 VA Practitioner - Nurse Practitioner 6305255027 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024175935VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BHG Lix, LLC CurrentSince Dec 5, 2025 Accepting new patients
BHG Lix, LLC CurrentSince Dec 5, 2025 Accepting new patients
BHG Xli, LLC Multi-Specialty CurrentSince Feb 5, 2021 Accepting new patients

Locations

5001 Spring Vly
Ste 600E
Dallas, TX 75244

109 Wimbledon Sq
Ste A
Chesapeake, VA 23320
Phone (757) 410-8244

3322 Western Branch Blvd
Ste A
Chesapeake, VA 23321
Phone (757) 673-3644

3356 Western Branch Blvd
Ste F
Chesapeake, VA 23321
Phone (214) 365-6132

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1639662489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 ANGLER CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233235345",
            "telephone_number": "443-956-3961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 ANGLER CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233235345",
            "telephone_number": "443-956-3961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAIWO",
        "first_name": "MARY",
        "middle_name": "OLUWATOYIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024175935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.