Individual provider Active NPI

Akinwale Stephen Akingbule, MD

  • Student in an Organized Health Care Education/Training Program
  • Dunn, NC
National Provider Identifier
1013650811
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
700 Tilghman Dr Ste 724
Dunn, NC 28334-5519
Phone
(417) 317-5318
Fax
(417) 763-3370
NPI assigned
Apr 19, 2022
Last updated
Mar 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Family Medicine Physician 207Q00000X 2021026653 MO

Addresses

Primary practice location

700 Tilghman Dr Ste 724
Dunn, NC 28334-5519

Mailing address

700 Tilghman Dr Ste 724
Dunn, NC 28334-5519
Phone (417) 317-5318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2021026653MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dunn Internal Medicine PastSince Apr 6, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1013650811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 TILGHMAN DR STE 724",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345519",
            "telephone_number": "417-317-5318",
            "fax_number": "417-763-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 TILGHMAN DR STE 724",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345519",
            "telephone_number": "417-317-5318",
            "fax_number": "417-763-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKINGBULE",
        "first_name": "AKINWALE",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-19",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2021026653",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.