Individual provider Active NPI

Stephen Olatunji Adekoya, PHARMACIST

  • Pharmacist
  • Baltimore, MD
National Provider Identifier
1780196642
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15541 Issued in MD
Practice address
2405 E Monument St
Baltimore, MD 21205-2542
Phone
(410) 276-4092
Fax
(410) 276-4094
NPI assigned
Nov 1, 2017
Last updated
Nov 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15541 MD Primary

Addresses

Primary practice location

2405 E Monument St
Baltimore, MD 21205-2542

Mailing address

2380 Sand Hill Rd
Ellicott City, MD 21042-1036

Other identifiers 1

IdentifierTypeStateIssuer
A320777660608OtherMDMARYLAND MVA

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15541MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peoples Services Inc Past Accepting new patients

Organizations & group practices 2

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": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1780196642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 SAND HILL RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 E MONUMENT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212052542",
            "telephone_number": "410-276-4092",
            "fax_number": "410-276-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEKOYA",
        "first_name": "STEPHEN",
        "middle_name": "OLATUNJI",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "15541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND MVA",
            "identifier": "A320777660608",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.