Individual provider Active NPI

Benedict Obi, NP

  • Registered Nurse
  • Burtonsville, MD
National Provider Identifier
1720405111
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN1030827 Issued in DC
Practice address
4301 Sgar Pine CT
Burtonsville, MD 20866
Phone
(301) 549-1202
NPI assigned
Mar 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R197119 MD
Registered Nurse 163W00000X RN1030827 DC Primary

Addresses

Primary practice location

4301 Sgar Pine CT
Burtonsville, MD 20866

Mailing address

4301 Sugar Pine CT
Burtonsville, MD 20866-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1030827DCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
PA Post Acute Services PC CurrentSince Jan 31, 2024 Accepting new patients

Locations

2525 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 367-9100

100 Laurel Dr
Elkton, MD 21921
Phone (410) 398-8800

3000 McComas Ave
Kensington, MD 20895
Phone (301) 491-3090

105 Time Sq
Salisbury, MD 21801
Phone (410) 749-2474

2601 Bel Pre Rd
Silver Spring, MD 20906
Phone (301) 598-6000

6700 Columbia Pike
Annandale, VA 22003
Phone (703) 256-7000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1720405111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 SUGAR PINE CT",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 SGAR PINE CT",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "20866",
            "telephone_number": "301-549-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBI",
        "first_name": "BENEDICT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-24",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R197119",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1030827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burtonsville, MD

Sources for this page

Verify at the official NPI Registry.