NPIMap

Individual provider Active NPI

Adedamola Adepoju, M.D

  • Neurological Surgery Physician
  • Sherwood, AR
National Provider Identifier
1003259979
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
E-12680 Issued in AR
Practice address
6020 Warden Rd Ste 100
Sherwood, AR 72120-6015
Phone
(501) 552-6400
Fax
(501) 552-6430
NPI assigned
Apr 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X E-12680 AR Primary

Addresses

Primary practice location

6020 Warden Rd Ste 100
Sherwood, AR 72120-6015

Mailing address

6020 Warden Rd Ste 100
Sherwood, AR 72120-6015
Phone (501) 552-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240517003174 OK Practitioner - Neurosurgery 3173868916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Massachusetts Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3433 NW 56TH St
Suite 900
Oklahoma City, OK 73112-4452
Phone (405) 552-0401

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • Integris Southwest Medical Center Hospital, Oklahoma City, OK, CCN 370106
  • Integris Canadian Valley Hospital Hospital, Yukon, OK, CCN 370211
  • Integris Health Enid Hospital Hospital, Enid, OK, CCN 370016
  • Duncan Regional Hospital, Inc Hospital, Duncan, OK, CCN 370023

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-12680ARMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince May 30, 2024 Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients

Locations

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

3001 Quail Springs Pkwy
Fl 5
Oklahoma City, OK 73134

3433 NW 56th St
Oklahoma City, OK 73112
Phone (405) 947-3341

3433 NW 56th St
Ste 900
Oklahoma City, OK 73112
Phone (405) 552-0401

Interoperability endpoints

  • Direct secure messaging: aadepoju486491@direct.integrisok.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IJAEAA/Endpoint/IJAEAA

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1003259979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 WARDEN RD STE 100",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721206015",
            "telephone_number": "501-552-6400",
            "fax_number": "501-552-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 WARDEN RD STE 100",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721206015",
            "telephone_number": "501-552-6400",
            "fax_number": "501-552-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEPOJU",
        "first_name": "ADEDAMOLA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-10",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AR",
            "license": "E-12680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, AR

Sources for this page

Verify at the official NPI Registry.