Individual provider Active NPI

Ishaq Olayinka Giwa, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1710643564
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R199309 Issued in MD
Practice address
1910 N Broadway Ste 101
Baltimore, MD 21213-1444
Phone
(410) 366-1893
NPI assigned
Nov 15, 2021
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R199309 MD Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 199309 MD

Addresses

Primary practice location

1910 N Broadway Ste 101
Baltimore, MD 21213-1444

Mailing address

8205 Reecewood Dr
Severn, MD 21144-3049
Phone (410) 499-3997

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
I20240502003207 MD Practitioner - Nurse Practitioner 5496195729

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
199309MDMDPsychiatric/Mental Health Nurse Practitioner
R199309MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Be-Live-It Therapy CurrentSince Jul 31, 2023 Accepting new patients

Locations

1910 N Broadway
Ste 101
Baltimore, MD 21213
Phone (410) 366-1893

Organizations & group practices 1

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": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1710643564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8205 REECEWOOD DR",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211443049",
            "telephone_number": "410-499-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 N BROADWAY STE 101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131444",
            "telephone_number": "410-366-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIWA",
        "first_name": "ISHAQ",
        "middle_name": "OLAYINKA",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-15",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R199309",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "199309",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.