Individual provider Active NPI

Olawale Adetayo Morafa, MD

  • Family Medicine Physician
  • Memphis, TN
National Provider Identifier
1013901222
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36735 Issued in TN
Practice address
2693 Union Avenue Ext
Suite 100
Memphis, TN 38112-4403
Phone
(901) 722-0088
Fax
(901) 722-0082
NPI assigned
Sep 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36735 TN Primary

Addresses

Primary practice location

2693 Union Avenue Ext
Suite 100
Memphis, TN 38112-4403

Mailing address

2693 Union Avenue Ext
Suite 100
Memphis, TN 38112-4403
Phone (901) 722-0088

Other identifiers 1

IdentifierTypeStateIssuer
Q010674MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060522000179 TN Practitioner - Family Practice 4789695149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2693 Union Ave Ext
Memphis, TN 38112-4403
Phone (901) 722-0088

2693 Union Ave Extended
Suite 100
Memphis, TN 38112-4403

Hospital & facility affiliations

  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36735TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Family Care, PC Family Medicine CurrentSince Jan 1, 2010 Accepting new patients
Shelby County Health Care Corporation Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Office of Internal Medicine, PC PastSince Mar 15, 2002 Accepting new patients
Cardiovascular Physicians of Memphis Past Accepting new patients

Locations

2693 Union Avenue Ext
Ste 100
Memphis, TN 38112
Phone (901) 722-0088

Interoperability endpoints

  • Direct secure messaging: omorafa31570@mlh.direct-ci.com

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 3

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1013901222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2693 UNION AVENUE EXT",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381124403",
            "telephone_number": "901-722-0088",
            "fax_number": "901-722-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2693 UNION AVENUE EXT",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381124403",
            "telephone_number": "901-722-0088",
            "fax_number": "901-722-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAFA",
        "first_name": "OLAWALE",
        "middle_name": "ADETAYO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "36735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q010674",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.