Sunrise Medical Clinic, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0065418 Issued in MD

Legal business name

SUNRISE MEDICAL CLINIC, LLC

Practice address

6201 Greenbelt Rd
Suite M-17
College Park, MD 20740-2354

Phone

(301) 220-9500

Fax

(301) 982-0321

NPI assigned

Jan 22, 2010

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

VITALIS O. OJIEGBE, MDAs reported in NPPES

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

Authorized official

Name

Mrs. Magdalene Ojiegbe

Title

Manager

Phone

(301) 220-3500

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Vitalis O. Ojiegbe, MD Other name

Part of

Sunrise Medical Clinic

Locations

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1871824391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1527",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207681527",
            "telephone_number": "301-220-9500",
            "fax_number": "301-982-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 GREENBELT RD",
            "address_2": "SUITE M-17",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207402354",
            "telephone_number": "301-220-9500",
            "fax_number": "301-982-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE MEDICAL CLINIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VITALIS O. OJIEGBE, MD",
        "enumeration_date": "2010-01-22",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "OJIEGBE",
        "authorized_official_first_name": "MAGDALENE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "301-220-3500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0065418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11328638",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027374100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitalis O. Ojiegbe, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jenna Stone, LCSW-C
• Keisha Renee Stubbs
• Esther Su
• Alhaji B Sualley
• Sucare Home Care Services
• Supreme Care
• Auja Sweeney, LMSW CAC-AD
• Patricia Swen
• Andrea Bessong Tabe
• Emily Mforenow Tabe

• Internal Medicine Physician in College Park, MD
• Providers in College Park, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.

Verify at the official NPI Registry.