Active NPI
Adetutu A Aina
- Family Nurse Practitioner
- Bowie, MD
National Provider Identifier
1710317680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R179523
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150424000487 | MD | Practitioner - Nurse Practitioner | 8820317829 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN1013550 | DC | MD | Family Nurse Practitioner |
| LG-0001037 | DE | MD | Family Nurse Practitioner |
| R179523 | MD | MD | Family Nurse Practitioner |
| SP017761 | PA | MD | Family Nurse Practitioner |
| 0024178021 | VA | MD | Family Nurse Practitioner |
Interoperability endpoints
- adetutu.aina.p1@direct.alegiscare.nextgenshare.com
- adetutu.aina.1@28492.direct.athenahealth.com
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.