MODUPE FADOJUTIMI (NPI# 1952860660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952860660 |
| Entity Type | Individual |
| Full Name | MODUPE FADOJUTIMI |
| Credential | NURSE PRACTITIONER |
| Practice Address |
1 Magnolia Dr La Plata MD 20646-9357 |
| Practice Telephone | 3019344001 |
| Mailing Telephone | 3019344001 |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2019-03-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
R194540 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1 MAGNOLIA DR |
| City | LA PLATA |
| State | MD |
| Zip Code | 20646-9357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457393191 | Meridian Healthcare, Inc | Skilled Nursing Facility | 1 Magnolia Dr, La Plata, MD 20646-9357 | 2006-06-10 |
| 1720575772 | Kelsea Thomas | Occupational Therapy Assistant | 1 Magnolia Dr, La Plata, MD 20646-9357 | 2018-04-16 |
| 1326492703 | 1 Magnolia Drive Operations LLC | Occupational Therapist | 1 Magnolia Dr, La Plata, MD 20646-9357 | 2016-04-21 |
| 1801267687 | Steven Keller | Occupational Therapy Assistant | 1 Magnolia Dr, La Plata, MD 20646-9357 | 2015-10-19 |
| 1851699961 | Adrienne Marie Gorretta | Occupational Therapy Assistant | 1 Magnolia Dr, La Plata, MD 20646-9357 | 2011-03-14 |
| 1245476746 | Tawnya Linn Cady | Occupational Therapy Assistant | 1 Magnolia Dr, La Plata, MD 20646-9357 | 2009-01-05 |
| 1033391503 | 1 Magnolia Drive Operations LLC | Skilled Nursing Facility | 1 Magnolia Dr, La Plata, MD 20646-9357 | 2007-11-27 |
| 1669665261 | Lisa Laclair | Physical Therapy Assistant | 1 Magnolia Dr, La Plata, MD 20646-9357 | 2007-08-27 |
| 1952507014 | Maria Cecilia Labor Camposano | Skilled Nursing Facility | 1 Magnolia Dr, La Plata, MD 20646-9357 | 2007-06-26 |
| 1831313071 | Genesis Rehab Services | Nursing Facility/Intermediate Care Facility | 1 Magnolia Dr, La Plata, MD 20646-9357 | 2007-04-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718822 | Charles Regional Surgical Center LLC | Clinic/Center | 5 North Laplata Court, 2nd Floor, Laplata, MD 20646 | 2020-07-27 |
| 1902387988 | Sheldon Villarta | Physical Therapist | 10200 La Plata Town, La Plata, MD 20646 | 2018-08-27 |
| 1912485244 | Kelli Hill Goldsborough | Nurse Practitioner | 5 N La Plata Ct Ste 101, La Plata, MD 20646 | 2018-07-30 |
| 1083128490 | Charles County Rescue Squad Inc | Ambulance | 2 Calvert St, La Plata, MD 20646 | 2017-11-21 |
| 1801261532 | Catherine Deshetler | Social Worker | 5 N Maple Ave Ste 206, La Plata, MD 20646 | 2015-12-07 |
| 1215346481 | Brittany Godin | Speech-Language Pathologist | 5 Garrett Avenue, La Plata, MD 20646 | 2014-08-12 |
| 1558787606 | Homeplace Assisted Living | Assisted Living Facility | 10210 La Plata Rd, La Plata, MD 20646 | 2014-03-13 |
| 1891056628 | Godfrey T Hewitt | Dentist | 6620 Crain Hwy #204, Laplata, MD 20646 | 2012-06-07 |
| 1740573823 | Armida Bondoc Gonzales | Physical Therapist | 15 S Maple Ave, Apt 2, La Plata, MD 20646 | 2011-05-23 |
| 1023315348 | Charity E Dugan | Surgery | Um Charles Regional Medical Group, 5 North La Plata Court Ste 103, La Plata, MP 20646 | 2011-02-23 |
| Find all providers in zip 20646 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912485244 | Kelli Hill Goldsborough | Nurse Practitioner | 5 N La Plata Ct Ste 101, La Plata, MD 20646 | 2018-07-30 |
| 1437569407 | Mandy Colegrove | Nurse Practitioner | 103 Centennial St, Suite B, La Plata, MD 20646-5984 | 2014-04-30 |
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| 1780298588 | Andreli Professional Advising and Resources, LLC | Nurse Practitioner | 9730 Morningview Cir, Perry Hall, MD 21128-9024 | 2020-08-31 |
| 1194336941 | Phoebe Vuwansi Chongong | Nurse Practitioner | 10300 Crystal Brook Ct, Upper Marlboro, MD 20772-6687 | 2020-08-14 |
| 1306457122 | Trusted and Innovative Inc | Nurse Practitioner | 4600 Powder Mill Rd Ste 450, Beltsville, MD 20705-2686 | 2020-08-14 |
| 1225653611 | Zynith Health Care & Associates | Nurse Practitioner | 4061 Powder Mill Rd Ste 101, Beltsville, MD 20705-3156 | 2020-06-11 |
| 1124640974 | Liberty Family Care | Nurse Practitioner | 8515 Liberty Rd Ste B, Randallstown, MD 21133-4832 | 2020-05-15 |
| 1437785706 | Hajia M Nagaiya | Nurse Practitioner | 3525 Courtleigh Dr, Baltimore, MD 21244-2205 | 2020-03-19 |
| 1578195475 | Baltimore Healthcare At Home, LLC | Nurse Practitioner | 9501 Branchleigh Rd, Randallstown, MD 21133-2056 | 2020-02-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.