Bowie Psychiatric Professional Associate LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BOWIE PSYCHIATRIC PROFESSIONAL ASSOCIATE LLC

Practice address

1007 Kings Heather Dr
Bowie, MD 20721-2010

Phone

(301) 648-9340

Fax

(301) 218-1090

NPI assigned

Oct 31, 2022

Organization subpart

No

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

Authorized official

Name

Olaolu Fadairo, NPNPI 1265025969

Title

Ceo

Phone

(301) 648-9340

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olaolu Fadairo, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bowie, MD
  • NPI 1265025969

  DC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1821705930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 KINGS HEATHER DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212010",
            "telephone_number": "301-648-9340",
            "fax_number": "301-218-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 KINGS HEATHER DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212010",
            "telephone_number": "301-648-9340",
            "fax_number": "301-218-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOWIE PSYCHIATRIC PROFESSIONAL ASSOCIATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "FADAIRO",
        "authorized_official_first_name": "OLAOLU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-648-9340",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Bowie, MD
• Providers in Bowie, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.