FAIRWOOD INTERNAL MEDICINE
NPI 1396986873
Internal Medicine in Glenn Dale, MD

Active since March 13, 2009
12200 ANNAPOLIS RD, SUITE 232, GLENN DALE, MD 20769(240) 245-4414(240) 245-4409 Get Directions Write a Review

NPPES record last updated: July 21, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Fairwood Internal Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRWOOD INTERNAL MEDICINE (NPI 1396986873) is a healthcare organization registered as an internal medicine in Glenn Dale, Maryland and active in the NPI registry since March 2009. The organization lists Okeowo Darcy Ibitoye, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1396986873
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameFAIRWOOD INTERNAL MEDICINE
Location Address12200 ANNAPOLIS RD, SUITE 232Glenn Dale, MD 20769-9180
Mailing Address12200 Annapolis Rd, Suite 232Glenn Dale, MD 20769-9180 · (240) 245-4414 · Fax (240) 245-4409
Fax(240) 245-4409
Organization SubpartNo
Authorized OfficialOkeowo Darcy IbitoyeMedical Director · (240) 245-4414
Enumeration DateMarch 13, 2009
Last NPPES UpdateJuly 21, 2009
✔ NPI 1396986873 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MD · D0051437
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
12200 ANNAPOLIS RD, Glenn Dale, MD 20769

Other Identifiers 4

Medicaid723540200MD
OtherP366MD · Carefirst Fep
OtherDX1GODMD · Carefirst Maryland
Medicare PIN146222MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fairwood Internal Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Fairwood Internal Medicine, which bills Medicare for the services this clinician delivers.

Clinician (1)

Internal Medicine
NPI 1154322352
2001 MEDICAL PKWY
Annapolis, MD 21401
(443) 481-1000
✔ PECOS✔ Accepts Medicare14 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fairwood Internal Medicine's NPI number?

The NPI number for Fairwood Internal Medicine is 1396986873. It was assigned to this organization in the NPPES registry on March 13, 2009.

Where is Fairwood Internal Medicine located?

Fairwood Internal Medicine is located at 12200 Annapolis Rd Suite 232, Glenn Dale, MD 20769. The listed phone number is (240) 245-4414.

What is Fairwood Internal Medicine's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Fairwood Internal Medicine enrolled in Medicare?

Yes. Fairwood Internal Medicine is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fairwood Internal Medicine?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Fairwood Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Fairwood Internal Medicine was last updated on July 21, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.