Individual provider Active NPI

Khadijat Adeyi

  • Licensed Practical Nurse
  • Mount Vernon, NY
National Provider Identifier
1053239582
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
341698 Issued in NY
Practice address
224 Hillside Ave
Mount Vernon, NY 10553-1808
Phone
(914) 510-3615
NPI assigned
Jul 10, 2026
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 341698 NY Primary

Addresses

Primary practice location

224 Hillside Ave
Mount Vernon, NY 10553-1808

Mailing address

224 Hillside Ave
Mount Vernon, NY 10553-1808

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

NPI Registry JSON

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

{
    "created_epoch": "1783641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1053239582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 HILLSIDE AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 HILLSIDE AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531808",
            "telephone_number": "914-510-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEYI",
        "first_name": "KHADIJAT",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-07-10",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "341698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.