Olubanke Babalola, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201605458NP-PP Issued in OR

Practice address

17979 NE Glisan St
Portland, OR 97230-6507

Phone

(888) 227-3312

NPI assigned

May 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 5

Medicare fee-for-service enrollment

Enrolled in TX, OR, WA, MT, AK5 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 5

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Express Care Ak LLCGroup PAC ID 2163855032, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: obabalola211034@oc.providencedirect.org

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.

• Express Care Ak LLC

  • Urgent Care Clinic/Center
  • Anchorage, AK
  • NPI 1770244568
  Medicare reassignment Care Compare group NPD
• Express Care Or PC

  • General Practice Physician
  • Portland, OR
  • NPI 1205499126

  WA

  Medicare reassignment
• Express Care Wa PC

  • General Practice Physician
  • Lacey, WA
  • NPI 1821554452

  MT

  Medicare reassignment
• Grace Clinic of Lubbock

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1912953357
  Medicare reassignment
• Express Care Ak LLC

  • Clinic/Center
  • Eagle River, AK
  • NPI 1376003095
  NPD (past)
• Providence Health & Services - Washington

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Hoquiam, WA
  • NPI 1043374119
  NPD (past)

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1013329002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3229",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17979 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972306507",
            "telephone_number": "888-227-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABALOLA",
        "first_name": "OLUBANKE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-23",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-157784",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61009656",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP125699",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201605458NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "obabalola211034@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4285 W Powell Blvd",
            "city": "Gresham",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970305050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "obabalola211034@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "14600 SW Murray Scholls Dr",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970079712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "obabalola211034@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4400 NE Halsey St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972131545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "obabalola211034@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "17979 NE Glisan St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972306507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "obabalola211034@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "11995 SE Sunnyside Rd",
            "city": "Happy Valley",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970159312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dalia Baadarani, M.S
• Kalina Mishel Baasten, PHARMD
• Michele Lynn Babaie
• Babak Govan PHD LLC
• Richard Babal, MANAGER
• Feliciana Babasa
• Brent Babauta, LMT
• Adetunji Olawale Babawale
• Denise Sterry Babawale
• Benjamin Albert Babb, M.D.

• Family Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.