Individual provider Active NPI

Comfort B Ogunlowo

  • Family Nurse Practitioner
  • Randallstown, MD
National Provider Identifier
1972292159
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R208424 Issued in MD
Practice address
5412 Old Court Rd
Randallstown, MD 21133-5104
Phone
(443) 985-1614
NPI assigned
May 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R208424 MD Primary

Addresses

Primary practice location

5412 Old Court Rd
Randallstown, MD 21133-5104

Mailing address

9535 Wesland Cir
Randallstown, MD 21133-2040
Phone (443) 985-1614

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
I20231007000145 DC Practitioner - Nurse Practitioner 1153776331 Reassigns benefits to 1 organization
I20231007000181 MD Practitioner - Nurse Practitioner 1153776331 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R208424MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optimize Medical Group CurrentSince Aug 23, 2023 Accepting new patients
Caringplus Healthcare Services Inc. CurrentSince May 7, 2023 Accepting new patients
Mid-South Home Care Services, LLC CurrentSince Apr 15, 2024 Accepting new patients
Mid-South Home Care Services, LLC CurrentSince Apr 15, 2024 Accepting new patients
Post Acute Health Care Services LLC Past Accepting new patients

Locations

1051 Brightseat Rd
Landover, MD 20785
Phone (240) 487-4400

1314 Bedford Ave
Ste 113
Pikesville, MD 21208
Phone (443) 868-7956

7001 Johnnycake Rd
Ste 204
Windsor Mill, MD 21244
Phone (410) 719-8670

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1972292159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9535 WESLAND CIR",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332040",
            "telephone_number": "443-985-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5412 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335104",
            "telephone_number": "443-985-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNLOWO",
        "first_name": "COMFORT",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R208424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

Verify at the official NPI Registry.