Olugbolahan Anifowose

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

26228 Issued in MD

Practice address

669 Wilbur SQ
Owings Mills, MD 21117-2479

Phone

(973) 336-4599

NPI assigned

Apr 23, 2017

Last updated

Apr 23, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Light Health ServicesGroup PAC ID 9931624079, 6 clinicians

Supreme Health and Rehabilitation Services, LLCGroup PAC ID 3971013863, 7 clinicians

Proactive Therapy, LLCGroup PAC ID 1951297092, 2 clinicians

Valuecare CorporationGroup PAC ID 0840688164, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Prime Light Health Services

  • Occupational Therapist
  • Edgewood, MD
  • NPI 1053120592

  Geriatrics

  Medicare reassignment Care Compare group NPD
• Proactive Therapy, LLC

  • Physical Therapist
  • Baltimore, MD
  • NPI 1023040128
  Medicare reassignment Care Compare group NPD
• Supreme Health and Rehabilitation Services, LLC

  dba Supreme Health Systems, LLC

  • Occupational Therapist
  • Reisterstown, MD
  • NPI 1881408417

  Geriatrics

  Medicare reassignment Care Compare group NPD
• Valuecare Corporation

  dba ValueCare Rehab

  • Physical Therapy Clinic/Center
  • Finksburg, MD
  • NPI 1134757818
  Medicare reassignment Care Compare group
• Reliant Therapy

  • Physical Therapy Clinic/Center
  • Owings Mills, MD
  • NPI 1629719943
  Authorized official Same address or phone
• Sovereignty Health Services LLC

  • Physical Therapy Clinic/Center
  • Randallstown, MD
  • NPI 1629699293
  NPD

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

{
    "created_epoch": "1492905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492905600000",
    "number": "1740715168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 WILBUR SQ",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211172479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 WILBUR SQ",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211172479",
            "telephone_number": "973-336-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANIFOWOSE",
        "first_name": "OLUGBOLAHAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-23",
        "last_updated": "2017-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "MD",
            "license": "26228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew I Pupkin DDS PA
• Marilyn Bochenko Andrews, MS, CANP
• Angel Lewis (Consulting Solutions)
• Duane Anglin, DDS
• Joseph Manoji Ntungue Angwafor, MD
• Olufunmi Victoria Anifowoshe
• Abiodun Anjorin
• Annapolis ENT Surgical Center LLC (Chesapeake Specialty Care)
• Annapolis ENT Surgical Center LLC (Chesapeake Specialty Care)
• Cynthia Ansah

• Geriatric Physical Therapist in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Geriatric Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.