Individual provider Active NPI

Omoseke Ruth Olasesan

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1912338716
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP500014011 Issued in DC
Practice address
14502 Greenview Dr Ste 428
Laurel, MD 20708-3287
Phone
(240) 604-7264
NPI assigned
Dec 3, 2013
Last updated
Feb 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP500014011 DC Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X R227198 MD

Addresses

Primary practice location

14502 Greenview Dr Ste 428
Laurel, MD 20708-3287

Mailing address

14502 Greenview Dr Ste 428
Laurel, MD 20708-3287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20240402000088 DC Practitioner - Nurse Practitioner 4082052758 Reassigns benefits to 1 organization
I20240515001925 MD Practitioner - Nurse Practitioner 4082052758 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Wellness Outpatient Mental Health Center LLC CurrentSince Apr 22, 2024 Accepting new patients
Arising Behavioral Health and Services LLC CurrentSince Jan 17, 2024 Accepting new patients
Sound Wellness Center Psychiatric/Mental Health CurrentSince May 1, 2024 Accepting new patients

Locations

1300 I St NW
Ste 400E
Washington, DC 20005
Phone (202) 902-7324

3310 Eastern Ave
Baltimore, MD 21224
Phone (443) 708-5056

8890 McDonogh Rd
Ste 208
Owings Mills, MD 21117
Phone (410) 559-6121

8890 McDonogh Rd
Ste 301
Owings Mills, MD 21117
Phone (410) 559-6121

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1912338716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14502 GREENVIEW DR STE 428",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207083287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 GREENVIEW DR STE 428",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207083287",
            "telephone_number": "240-604-7264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLASESAN",
        "first_name": "OMOSEKE",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-03",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "NP500014011",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R227198",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.