Individual provider Active NPI

Odunola Adeyeye

  • Psychiatric/Mental Health Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1710609763
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R225954 Issued in MD
Practice address
1519 W Patrick St Ste A1
Frederick, MD 21702-3763
Phone
(202) 838-7211
NPI assigned
Sep 15, 2022
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R225954 MD Primary

Addresses

Primary practice location

1519 W Patrick St Ste A1
Frederick, MD 21702-3763

Mailing address

PO Box 473
Linthicum Heights, MD 21090-0473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20230711000039 MD Practitioner - Nurse Practitioner 4183083058 Reassigns benefits to 4 organizations
I20250102000013 DC Practitioner - Nurse Practitioner 4183083058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians
JK Health SystemsGroup PAC ID 4688166093, 2 clinicians

Practice addresses (Care Compare)

Glen Burnie, MD 21061
Phone (202) 344-5706

1910 Towne Centre Blvd
Suite 250
Annapolis, MD 21401-3599
Phone (866) 630-0966

3620 S Hanover St
Baltimore, MD 21225-1705
Phone (443) 579-6044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R225954MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Nov 27, 2024 Accepting new patients
JK Health Systems CurrentSince Sep 8, 2025 Accepting new patients
Bridging Gaps Through Positive Solutions CurrentSince Jun 12, 2024 Accepting new patients
Bridging Gaps Through Positive Solutions CurrentSince Jun 12, 2024 Accepting new patients
Sondermind Provider Network LLC Psychiatric/Mental Health CurrentSince Apr 15, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1910 Towne Centre Blvd
Ste 250
Annapolis, MD 21401
Phone (202) 596-8891

3620 S Hanover St
Baltimore, MD 21225
Phone (410) 354-2200

8508 Loch Raven Blvd
Towson, MD 21286
Phone (410) 296-7222

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 7

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": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1710609763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 473",
            "city": "LINTHICUM HEIGHTS",
            "state": "MD",
            "postal_code": "210900473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 W PATRICK ST STE A1",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217023763",
            "telephone_number": "202-838-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEYEYE",
        "first_name": "ODUNOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2024-11-05",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R225954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.