Active NPI
Olumide Ogunjuyigbe, PT
- Physical Therapist
- Bowie, MD
National Provider Identifier
1821293036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- MD18415
- Practice address
- 2909 Eagles Nest Dr
Bowie, MD 20716-3905 - Phone
- (202) 498-0484
- Fax
- (301) 805-0634
- NPI assigned
- Jun 18, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | MD18415 | DC | Primary |
Addresses
Primary practice location
2909 Eagles Nest Dr
Bowie, MD 20716-3905
Mailing address
2909 Eagles Nest Dr
Bowie, MD 20716-3905
Phone (202) 498-0484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5556 | Medicaid | DC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18415 | MD | MD | Pharmacist |
| MD18415 | DC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Favous Healthcare Services | Past | Accepting new patients | |
| Favous Therapy Inc | Physical Therapist | 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 and National Provider Directory roles.
-
- Physical Therapist
- Bowie, MD
- NPI 1376721571
-
- Home Health Agency
- Bowie, MD
- NPI 1982844015
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1821293036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2909 EAGLES NEST DR",
"city": "BOWIE",
"state": "MD",
"postal_code": "207163905",
"telephone_number": "202-498-0484",
"fax_number": "301-805-0634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2909 EAGLES NEST DR",
"city": "BOWIE",
"state": "MD",
"postal_code": "207163905",
"telephone_number": "202-498-0484",
"fax_number": "301-805-0634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OGUNJUYIGBE",
"first_name": "OLUMIDE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DC",
"license": "MD18415",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5556",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.