Exedus Family Healthcare & Wellness Care Services LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

EXEDUS FAMILY HEALTHCARE & WELLNESS CARE SERVICES LLC

Practice address

11410 Merrick Blvd
Jamaica, NY 11434-1335

Phone

(718) 233-2972

Fax

(667) 771-0892

NPI assigned

Aug 8, 2023

Last updated

Feb 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Omotunde D Aderin, DNP, APRNNPI 1881248938

Title

Ceo

Phone

(718) 233-2972

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Omotunde D Aderin, NP

  • Family Nurse Practitioner
  • Amityville, NY
  • NPI 1881248938
  Authorized official Same address or phone

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1023791928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WINTER LN",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117011626",
            "telephone_number": "917-653-0577",
            "fax_number": "667-771-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11410 MERRICK BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341335",
            "telephone_number": "718-233-2972",
            "fax_number": "667-771-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXEDUS FAMILY HEALTHCARE & WELLNESS CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-08",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "ADERIN",
        "authorized_official_first_name": "OMOTUNDE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-233-2972",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.