Individual provider Active NPI

Lilian Ifeyinwa Agwumezie, FNP

  • Family Medicine Physician
  • Clinton, MD
National Provider Identifier
1972471019
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2025026242 Issued in MD
Practice address
7700 Old Branch Ave Ste B201
Clinton, MD 20735-1605
Phone
(301) 289-7722
Fax
(202) 618-6201
NPI assigned
Oct 29, 2025
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2025026242 MD Primary

Addresses

Primary practice location

7700 Old Branch Ave Ste B201
Clinton, MD 20735-1605

Mailing address

1519 Kingshill St
Bowie, MD 20721-2036
Phone (301) 556-8267

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
2025026242MDMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1972471019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 KINGSHILL ST",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212036",
            "telephone_number": "301-556-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 OLD BRANCH AVE STE B201",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351605",
            "telephone_number": "301-289-7722",
            "fax_number": "202-618-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGWUMEZIE",
        "first_name": "LILIAN",
        "middle_name": "IFEYINWA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "2025026242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.