Individual provider Active NPI

Abidemi Olaoye Ajibola, APRN

  • Family Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1023732609
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11021967 Issued in FL
Practice address
14 W Jordan St Ste 150
Pensacola, FL 32501-1740
Phone
(850) 455-1252
Fax
(844) 683-8754
NPI assigned
Sep 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11021967 FL Primary
Acute Care Nurse Practitioner 363LA2100X APRN11021967 FL

Addresses

Primary practice location

14 W Jordan St Ste 150
Pensacola, FL 32501-1740

Mailing address

14 W Jordan St Ste 150
Pensacola, FL 32501-1740
Phone (850) 455-1252

Other identifiers 1

IdentifierTypeStateIssuer
116619200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230111003193 FL Practitioner - Nurse Practitioner 9537539366 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pensacola Emergency Physicians, LLC CurrentSince May 15, 2023 Accepting new patients
Jdpremium Healthcare, LLC Family CurrentSince Dec 31, 2022 Accepting new patients
Pensacola Emergency Physicians, LLC CurrentSince May 15, 2023 Accepting new patients
Minuteclinic LLC Nurse Practitioner CurrentSince Dec 15, 2022 Accepting new patients
Sunshine Pediatrics Past Accepting new patients

Locations

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

14 W Jordan St
Ste 150
Pensacola, FL 32501
Phone (850) 455-1252

8100 N Davis Hwy
Pensacola, FL 32514
Phone (850) 454-9934

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

14 W Jordan St
Ste 1J
Pensacola, FL 32501
Phone (850) 432-9023

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1023732609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 W JORDAN ST STE 150",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011740",
            "telephone_number": "850-455-1252",
            "fax_number": "844-683-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 W JORDAN ST STE 150",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011740",
            "telephone_number": "850-455-1252",
            "fax_number": "844-683-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJIBOLA",
        "first_name": "ABIDEMI",
        "middle_name": "OLAOYE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11021967",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11021967",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116619200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.