Oluwakemi F Balogun

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R200367 Issued in MD

Practice address

7310 Ritchie Hwy Ste 519
Glen Burnie, MD 21061-3099

Phone

(301) 501-5779

NPI assigned

Mar 28, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medhaven Health LLCGroup PAC ID 2062894280, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Medhaven Health LLC

  • Health Service Clinic/Center
  • Glen Burnie, MD
  • NPI 1710618152

  MD, Multi-Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Health Releaf LLC

  • Primary Care Clinic/Center
  • Glen Burnie, MD
  • NPI 1235616475

  MD, Multi-Specialty

  Medicare reassignment NPD
• Mdics Rehabilitative Services LLC

  • Internal Medicine Physician
  • Glen Burnie, MD
  • NPI 1124313309

  DC, Multi-Specialty

  Medicare reassignment NPD
• Ebube E.Odunukwe, M.D.,P.C.

  • Medical Specialty Clinic/Center
  • Glen Burnie, MD
  • NPI 1689942187

  Multi-Specialty

  NPD
• Post Acute Health Care Services LLC

  • Acute Care Nurse Practitioner
  • Pikesville, MD
  • NPI 1982423653

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1962963389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 RITCHIE HWY STE 519",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613099",
            "telephone_number": "301-501-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 RITCHIE HWY STE 519",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613099",
            "telephone_number": "301-501-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALOGUN",
        "first_name": "OLUWAKEMI",
        "middle_name": "F",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "R200367",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R200367",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R200367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akeem Adeniyi Bakare, PT
• Debra Lynn Baker, R.N.
• Ronald Wayne Baker, P.D.
• Tennille Lisette Ball
• Esperanza Ballenilla, LCSW-C
• Baltimore Vamc
• Baltimore Washington Durable Medical Equipment, LLC
• Baltimore Washington Emergency Physicians, Inc.
• Baltimore Washington Medical Center
• Baltimore Washington Medical Center Inc.

• All providers in Glen Burnie, MD
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.