Active NPI
Olubukola Segun Bankole
- Home Health Aide
- Owings Mills, MD
National Provider Identifier
1801677570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- RSA-02078
- Practice address
- 24 Gwynnswood Rd
Owings Mills, MD 21117-1767 - Phone
- (240) 938-4107
- NPI assigned
- Oct 10, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | RSA-02078 | MD | Primary |
Addresses
Primary practice location
24 Gwynnswood Rd
Owings Mills, MD 21117-1767
Mailing address
24 Gwynnswood Rd
Owings Mills, MD 21117-1767
Phone (240) 938-4107
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
| License | State | Type | Specialty |
|---|---|---|---|
| RSA-02078 | MD | MD | Home Health Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glorious Healthcare Inc | Multi-Specialty | Current | Accepting new patients |
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": "1696896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1801677570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 GWYNNSWOOD RD",
"city": "OWINGS MILLS",
"state": "MD",
"postal_code": "211171767",
"telephone_number": "240-938-4107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 GWYNNSWOOD RD",
"city": "OWINGS MILLS",
"state": "MD",
"postal_code": "211171767",
"telephone_number": "240-938-4107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANKOLE",
"first_name": "OLUBUKOLA",
"middle_name": "SEGUN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-10",
"last_updated": "2023-10-10",
"certification_date": "2023-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Home Health Aide",
"state": "MD",
"license": "RSA-02078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owings Mills, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.