Individual provider Active NPI

Adetutu A Aina

  • Family Nurse Practitioner
  • Bowie, MD
National Provider Identifier
1710317680
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R179523 Issued in MD
Practice address
16314 Alderwood LN
Bowie, MD 20716-1511
Phone
(240) 821-0858
NPI assigned
Nov 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN1013550 DC
Family Nurse Practitioner 363LF0000X 0024178021 VA
Family Nurse Practitioner 363LF0000X LG-0001037 DE
Family Nurse Practitioner 363LF0000X SP017761 PA
Family Nurse Practitioner 363LF0000X R179523 MD Primary

Addresses

Primary practice location

16314 Alderwood LN
Bowie, MD 20716-1511

Mailing address

16314 Alderwood LN
Bowie, MD 20716-1511
Phone (240) 821-0858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150424000487 MD Practitioner - Nurse Practitioner 8820317829

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1013550DCMDFamily Nurse Practitioner
LG-0001037DEMDFamily Nurse Practitioner
R179523MDMDFamily Nurse Practitioner
SP017761PAMDFamily Nurse Practitioner
0024178021VAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: adetutu.aina.p1@direct.alegiscare.nextgenshare.com
  • Direct secure messaging: adetutu.aina.1@28492.direct.athenahealth.com
  • Direct secure messaging: adetutu.aina.p2@direct.alegiscare.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1384300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1710317680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16314 ALDERWOOD LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161511",
            "telephone_number": "240-821-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16314 ALDERWOOD LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161511",
            "telephone_number": "240-821-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AINA",
        "first_name": "ADETUTU",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-13",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1013550",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178021",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0001037",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017761",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R179523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.