Individual provider Active NPI

Olajumoke O Ogunfiditimi, CRNP

  • Gerontology Nurse Practitioner
  • Olney, MD
National Provider Identifier
1932967254
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R226377 Issued in MD
Practice address
3413 Olandwood CT
Olney, MD 20832-1489
Phone
(240) 786-1001
NPI assigned
Mar 11, 2024
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R226377 MD Primary

Addresses

Primary practice location

3413 Olandwood CT
Olney, MD 20832-1489

Mailing address

3413 Olandwood CT
Olney, MD 20832-1489
Phone (240) 786-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20240712000087 DC Practitioner - Nurse Practitioner 7012452238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Frederick Health Hospital IncGroup PAC ID 0446149256, shared by 8 NPIs, 127 clinicians
Choice Pain and Rehabilitation Center LLCGroup PAC ID 1850534645, 13 clinicians

Practice addresses (Care Compare)

1194 Dutchmans Creek Dr
Brunswick, MD 21716-9786
Phone (240) 215-6310

18540 Office Park Dr
Montgomery Village, MD 20886-0586
Phone (240) 786-1001

3413 Olandwood CT
Suite 103
Olney, MD 20832-1489
Phone (240) 786-1001

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Pain & Rehabilitation Center CurrentSince Jun 15, 2024 Accepting new patients
Choice Pain & Rehabilitation Center, LLC CurrentSince Jun 15, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

8843 Greenbelt Rd
Greenbelt, MD 20770
Phone (240) 297-9857

7404 Executive Pl
Lanham, MD 20706
Phone (202) 390-1115

7404 Executive Pl
Ste 510
Lanham, MD 20706

14205 Park Center Dr
Ste 204
Laurel, MD 20707
Phone (301) 853-0093

18540 Office Park Dr
Montgomry Vlg, MD 20886
Phone (301) 330-3900

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": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1932967254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3413 OLANDWOOD CT",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321489",
            "telephone_number": "240-786-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 OLANDWOOD CT",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321489",
            "telephone_number": "240-786-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNFIDITIMI",
        "first_name": "OLAJUMOKE",
        "middle_name": "O",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R226377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.