Individual provider Active NPI

Caroline Ogunmuyiwa, REGISTERED NURSE

  • Administrator Registered Nurse
  • Ellicott City, MD
National Provider Identifier
1972320281
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
R206341 Issued in MD
Practice address
12212 Fawnhaven CT
Ellicott City, MD 21042-1323
Phone
(202) 531-5924
NPI assigned
Sep 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X R206341 MD
Administrator Registered Nurse 163WA2000X R206341 MD Primary

Addresses

Primary practice location

12212 Fawnhaven CT
Ellicott City, MD 21042-1323

Mailing address

12212 Fawnhaven CT
Ellicott City, MD 21042-1323
Phone (202) 531-5924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R206341MDMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Carebridge Inc CurrentSince Jul 13, 2025 Accepting new patients
Carebridge Inc CurrentSince Sep 29, 2024 Accepting new patients

Organizations & group practices 2

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": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1972320281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12212 FAWNHAVEN CT",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421323",
            "telephone_number": "202-531-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12212 FAWNHAVEN CT",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421323",
            "telephone_number": "202-531-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNMUYIWA",
        "first_name": "CAROLINE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MD",
            "license": "R206341",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "MD",
            "license": "R206341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.