Olasunmbo I Feyisetan, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R182535 Issued in MD

Practice address

6095 Marshalee Dr
Elkridge, MD 21075

Phone

(443) 761-7049

NPI assigned

Apr 4, 2016

Sex

Female

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

Enrolled in MD

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1922461227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6095 MARSHALEE DR",
            "address_2": "SUITE 100",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756053",
            "telephone_number": "443-761-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6095 MARSHALEE DR",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "21075",
            "telephone_number": "443-761-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEYISETAN",
        "first_name": "OLASUNMBO",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R182535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faith Health Group LLC
• Family Dental Wellness Center
• Family Medical Wellness Center LLC
• Zijuan Fan, DDS
• Felice Physical Therapy
• Roy J Film, P.T.
• First Call Occupational Health
• First Level ABA, LLC
• Corinne Fitchett, MSW, LMHP-S
• Ngocbich Lam Florentino, DDS

• Nurse Practitioner in Elkridge, MD
• Providers in Elkridge, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.