Individual provider Active NPI

Adetimbo Adediran, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Owings Mills, MD
National Provider Identifier
1679922298
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R194824 Issued in MD
Practice address
9435 Paragon CT
Owings Mills, MD 21117-1408
Phone
(240) 722-9763
NPI assigned
Jun 4, 2016
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R194854 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R194824 MD Primary

Addresses

Primary practice location

9435 Paragon CT
Owings Mills, MD 21117-1408

Mailing address

9435 Paragon CT
Owings Mills, MD 21117-1408
Phone (240) 722-9763

Other practice location 1

7503 Surratts Rd
Clinton, MD 20735-3358
Phone (202) 360-4787

Other practice location 2

11236 Robinwood Dr
Suite 101
Hagerstown, MD 21742-6708
Phone (240) 313-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20161011000053 MD Practitioner - Nurse Practitioner 4082902937 Reassigns benefits to 6 organizations
I20161011000913 DC Practitioner - Nurse Practitioner 4082902937 Reassigns benefits to 5 organizations
I20240117004042 NY Practitioner - Nurse Practitioner 4082902937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axis Healthcare GroupGroup PAC ID 1254409550, 76 clinicians
Parker Psychiatric Services IncorporatedGroup PAC ID 7113322835, 3 clinicians

Practice addresses (Care Compare)

1117 E W Hwy
Silver Spring, MD 20910-4852
Phone (202) 360-4787

1150 Varnum St NE
Washington, DC 20017-2180
Phone (202) 360-4787

7503 Surratts Rd
Clinton, MD 20735-3358
Phone (202) 360-4787

8040 Georgia Ave
Suite 170
Silver Spring, MD 20910-4959
Phone (202) 360-4787

940 Madison Ave
Suite 202
Baltimore, MD 21201-2113
Phone (410) 777-8710

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R194854MDMDFamily Nurse Practitioner
R194824MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Graceland Psychiatry LLC Psychiatric/Mental Health CurrentSince Apr 7, 2021 Accepting new patients
Axis Healthcare Group CurrentSince Apr 19, 2022 Accepting new patients
Advance Mobile Health Solutions Family Current Accepting new patients
Psychogeriatric Services LLC CurrentSince May 10, 2019 Accepting new patients
Victory Springs, Inc CurrentSince Nov 12, 2018 Accepting new patients
Kurup Wound Care, Inc. CurrentSince Sep 5, 2016 Accepting new patients
Medical Director Services PC CurrentSince Nov 5, 2023 Accepting new patients
Parker Psychiatric Services, Incorporated CurrentSince Sep 29, 2022 Accepting new patients
Interdynamics, Inc. Psychiatric/Mental Health CurrentSince Dec 20, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
MCS, PC Psychiatric/Mental Health Past Accepting new patients
Interdynamics, Inc. PastSince Dec 20, 2021 Accepting new patients
Post Acute Health Care Services LLC Past Accepting new patients

Locations

1150 Varnum St NE
Washington, DC 20017
Phone (202) 269-7000

900 Van Buren St
Annapolis, MD 21403
Phone (301) 933-2500

940 Madison Ave
#202
Baltimore, MD 21201
Phone (410) 777-8710

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

1835 University Blvd E
Ste 208
Hyattsville, MD 20783
Phone (301) 445-3501

4922 Lasalle Rd
Hyattsville, MD 20782
Phone (301) 445-3501

8181 Professional Pl
Ste 200
Landover, MD 20785
Phone (301) 306-4590

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

4101 Old National Pike
Mount Airy, MD 21771
Phone (301) 829-0800

10451 Mill Run Cir
Ste 400
Owings Mills, MD 21117
Phone (443) 219-8482

19 Walker Ave
Ste 203
Pikesville, MD 21208
Phone (410) 526-1490

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

3227 Bel Pre Rd
Silver Spring, MD 20906
Phone (301) 871-2000

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1679922298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9435 PARAGON CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171408",
            "telephone_number": "240-722-9763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9435 PARAGON CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171408",
            "telephone_number": "240-722-9763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7503 Surratts Rd",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MD",
            "postal_code": "207353358",
            "country_code": "US",
            "telephone_number": "202-360-4787",
            "fax_number": "202-360-4787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11236 Robinwood Dr",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217426708",
            "country_code": "US",
            "telephone_number": "240-313-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADEDIRAN",
        "first_name": "ADETIMBO",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-04",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R194854",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R194824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.