Individual provider Active NPI

Josephus Idowu, RN

  • Psychiatric/Mental Health Registered Nurse
  • Temple Hills, MD
National Provider Identifier
1700332673
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
R1003138912 Issued in DC
Practice address
4608 Sharon Rd
Temple Hills, MD 20748-3738
Phone
(202) 704-1090
NPI assigned
Aug 30, 2016
Last updated
Aug 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X R1003138912 DC Primary
Case Management Registered Nurse 163WC0400X 1700332673. DC
Registered Nurse 163W00000X 1700332673. DC
Home Health Registered Nurse 163WH0200X 1700332673. DC
Pain Management Registered Nurse 163WP0000X 1700332673. DC
Psychiatric/Mental Health Registered Nurse 163WP0808X 1700332673. DC
Continence Care Registered Nurse 163WC2100X 1700332673. DC
Administrator Registered Nurse 163WA2000X 1700332673. DC
Rehabilitation Registered Nurse 163WR0400X 1700332673. DC
Nursing Home Administrator 376G00000X 1700332673. DC
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 1700332673. DC

Addresses

Primary practice location

4608 Sharon Rd
Temple Hills, MD 20748-3738

Mailing address

4608 Sharon Rd
Temple Hills, MD 20748-3738
Phone (202) 704-1090

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1700332673.DCMDCase Management Registered Nurse
R1003138912DCMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
American Healthcare Plus Inc. Current Accepting new patients
Trinity Health LLC Current Accepting new patients

Locations

1817 W Virginia Ave NE
Washington, DC 20002
Phone (202) 248-8114

Organizations & group practices 9

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": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1700332673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 SHARON RD",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207483738",
            "telephone_number": "202-704-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 SHARON RD",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207483738",
            "telephone_number": "202-704-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDOWU",
        "first_name": "JOSEPHUS",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "DC",
            "license": "R1003138912",
            "primary": true
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "DC",
            "license": "1700332673.",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "1700332673.",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "DC",
            "license": "1700332673.",
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "DC",
            "license": "1700332673.",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "DC",
            "license": "1700332673.",
            "primary": false
        },
        {
            "code": "163WC2100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continence Care",
            "state": "DC",
            "license": "1700332673.",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "DC",
            "license": "1700332673.",
            "primary": false
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "DC",
            "license": "1700332673.",
            "primary": false
        },
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "DC",
            "license": "1700332673.",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "DC",
            "license": "1700332673.",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Hills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.