Individual provider Active NPI

Ogechi Lilian Ogbolu

  • Adult Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1831899327
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R223651 Issued in MD
Practice address
201 E University Pkwy
Baltimore, MD 21218-2829
Phone
(410) 554-2000
NPI assigned
Mar 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R223651 MD Primary

Addresses

Primary practice location

201 E University Pkwy
Baltimore, MD 21218-2829

Mailing address

3264 Kaiser Dr
Ellicott City, MD 21043-4555
Phone (410) 206-3227

Other names 1

  • Miss Ogechi Lilian Okoro Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231116000049 MD Practitioner - Nurse Practitioner 3577910348 Reassigns benefits to 3 organizations
I20231116000240 DC Practitioner - Nurse Practitioner 3577910348 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CNP Operating Co LLCGroup PAC ID 8325263734, 63 clinicians

Practice addresses (Care Compare)

105 Time SQ
Salisbury, MD 21801-2808
Phone (410) 749-2474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R223651MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PA Post Acute Services PC CurrentSince May 27, 2024 Accepting new patients
CNP Operating Co LLC CurrentSince Jun 2, 2024 Accepting new patients
Optimize Medical Group Adult Health CurrentSince Oct 3, 2023 Accepting new patients
Post Acute Health Care Services LLC Past Accepting new patients

Locations

2525 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 367-9100

100 Laurel Dr
Elkton, MD 21921
Phone (410) 398-8800

1051 Brightseat Rd
Landover, MD 20785
Phone (240) 487-4400

1314 Bedford Ave
Ste 113
Pikesville, MD 21208
Phone (443) 868-7956

105 Time Sq
Salisbury, MD 21801
Phone (410) 749-2474

Organizations & group practices 4

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": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1831899327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 KAISER DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434555",
            "telephone_number": "410-206-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E UNIVERSITY PKWY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182829",
            "telephone_number": "410-554-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBOLU",
        "first_name": "OGECHI",
        "middle_name": "LILIAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R223651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OGECHI",
            "last_name": "OKORO",
            "middle_name": "LILIAN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.