Individual provider Active NPI

Promise A Olomo, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbia, MD
National Provider Identifier
1760911853
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R186662 Issued in MD
Practice address
11085 Little Patuxent Pkwy BLDG 4
Columbia, MD 21044-2983
Phone
(410) 730-0099
Fax
(410) 964-1345
NPI assigned
Jun 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R186662 MD Primary

Addresses

Primary practice location

11085 Little Patuxent Pkwy BLDG 4
Columbia, MD 21044-2983

Mailing address

9910 Franklin Square Dr Ste 2110
Baltimore, MD 21236-4902
Phone (410) 933-6423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R186662MDMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1760911853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR STE 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-933-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11085 LITTLE PATUXENT PKWY BLDG 4",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442983",
            "telephone_number": "410-730-0099",
            "fax_number": "410-964-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOMO",
        "first_name": "PROMISE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R186662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.