Famous Iwinosa Osasuyi

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Practice address

11555 Autumn Terrace Dr
White Marsh, MD 21162-1152

Phone

(443) 226-6339

Fax

(443) 919-0209

NPI assigned

Mar 24, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1902268352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 AUTUMN TERRACE DR",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211621152",
            "telephone_number": "443-226-6339",
            "fax_number": "443-919-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 AUTUMN TERRACE DR",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211621152",
            "telephone_number": "443-226-6339",
            "fax_number": "443-919-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSASUYI",
        "first_name": "FAMOUS",
        "middle_name": "IWINOSA",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-24",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in White Marsh, MD
• Providers in White Marsh, MD by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; 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.