Individual provider Active NPI

Ayo Okoro, FAMILY NURSE PRACTIT

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1972841856
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R140642 Issued in MD
Practice address
14625 Baltimore Avenue
Suite 327
Laurel, MD 20707
Phone
(301) 256-8766
NPI assigned
Jan 28, 2013
Last updated
Apr 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R140642 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R140642 MD Primary
Registered Nurse 163W00000X R140642 MD

Addresses

Primary practice location

14625 Baltimore Avenue
Suite 327
Laurel, MD 20707

Mailing address

14625 Baltimore Ave Ste 327
Laurel, MD 20707-4902
Phone (301) 256-8766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, WV, GA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20180827000162 MD Practitioner - Nurse Practitioner 3274882220 Reassigns benefits to 1 organization
I20190329000701 DC Practitioner - Nurse Practitioner 3274882220 Reassigns benefits to 1 organization
I20221102000710 WV Practitioner - Nurse Practitioner 3274882220 Reassigns benefits to 1 organization
I20221117001597 GA Practitioner - Nurse Practitioner 3274882220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11226 Cherry Hill Rd
Apt 302
Beltsville, MD 20705-3831
Phone (301) 907-1700

611 Summit N Dr NE
Atlanta, GA 30324-3143
Phone (301) 907-1700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R140642MDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rose Godwin Support Services, Inc Psychiatric/Mental Health CurrentSince Aug 10, 2018 Accepting new patients

Locations

14625 Baltimore Ave
Laurel, MD 20707
Phone (240) 243-9586

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1972841856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14625 BALTIMORE AVE STE 327",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074902",
            "telephone_number": "301-256-8766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14625 BALTIMORE AVENUE",
            "address_2": "SUITE 327",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "301-256-8766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKORO",
        "first_name": "AYO",
        "credential": "FAMILY NURSE PRACTIT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-28",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R140642",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R140642",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R140642",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.