NPIMap

Individual provider Active NPI

Abimbola A Ogunleye-Kolawole, DNP, FNP-C

  • Family Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1023294261
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
231011 Issued in NC
Practice address
3616 Cape Center Dr Ste a
Fayetteville, NC 28304-4456
Phone
(910) 779-0780
Fax
(910) 900-8280
NPI assigned
Jan 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 231011 NC Primary

Addresses

Primary practice location

3616 Cape Center Dr Ste a
Fayetteville, NC 28304-4456

Mailing address

3616 Cape Center Dr Ste a
Fayetteville, NC 28304-4456
Phone (910) 779-0780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20100331001288 NC Practitioner - Nurse Practitioner 7214010495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

2303 Wellington Dr SW
Wilson, NC 27893-8620
Phone (252) 243-6818

3616 Cape Ctr Dr
Fayetteville, NC 28304-4456
Phone (910) 900-8294

Hospital & facility affiliations

  • Amedisys Home Health of Fayetteville Home health agency, Fayetteville, NC, CCN 347132
  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Family Practice and Urgent Care, PLLC Current Accepting new patients
Divine Family Practice and Urgent Care, PLLC CurrentSince Nov 4, 2019 Accepting new patients

Locations

3616 Cape Center Dr
#A
Fayetteville, NC 28304
Phone (910) 779-0780

526 Sandhurst Dr
Fayetteville, NC 28304
Phone (910) 900-8294

3616 Cape Center Dr
Fayetteville, NC 28304
Phone (910) 779-0780

Interoperability endpoints

  • Direct secure messaging: divinefamilypracticeandurgentcare.abimbolaogunleyekolawole@162921.advancedmd-direct.com

Organizations & group practices 2

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1023294261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3616 CAPE CENTER DR STE A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044456",
            "telephone_number": "910-779-0780",
            "fax_number": "910-900-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3616 CAPE CENTER DR STE A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044456",
            "telephone_number": "910-779-0780",
            "fax_number": "910-900-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNLEYE-KOLAWOLE",
        "first_name": "ABIMBOLA",
        "middle_name": "A",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-17",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "231011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.