Individual provider Active NPI

Igbagboyemi Temidayo Olatunde, M.D

  • Internal Medicine Physician
  • Columbia, SC
National Provider Identifier
1053752105
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
88536 Issued in SC
Practice address
1850 Laurel St
Columbia, SC 29201-2627
Phone
(803) 376-5982
Fax
(803) 376-5987
NPI assigned
Jul 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 88536 SC Primary
Internal Medicine Physician 207R00000X 35.134246 OH

Addresses

Primary practice location

1850 Laurel St
Columbia, SC 29201-2627

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

140 Morris Rd
Circleville, OH 43113-1362
Phone (740) 420-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena.fam.med.circleville@adena.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161020002263 NJ Practitioner - HospitalistPractitioner - Internal Medicine 1951689298 Reassigns benefits to 1 organization
I20221109002164 SC Practitioner - Internal Medicine 1951689298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

1850 Laurel St
Suite 1a
Columbia, SC 29201-2658
Phone (803) 256-6400

Hospital & facility affiliations

  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018
  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
88536SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Internal Medicine CurrentSince Oct 3, 2022 Accepting new patients
Hospitalist Medicine Physicians of Pennsylvania, P.C. Internal Medicine CurrentSince Aug 27, 2016 Accepting new patients
Cogent Healthcare of New Jersey, PC Internal Medicine CurrentSince Aug 27, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Oct 3, 2022 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1850 Laurel St
Ste 1A
Columbia, SC 29201
Phone (803) 296-7305

1850 Laurel St
Columbia, SC 29201
Phone (803) 256-3400

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Interoperability endpoints

  • Direct secure messaging: iolatunde622815@direct.ghs.myhfn.org

Organizations & group practices 4

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 8

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": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1053752105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 LAUREL ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012627",
            "telephone_number": "803-376-5982",
            "fax_number": "803-376-5987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 MORRIS RD",
            "address_purpose": "LOCATION",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431131362",
            "country_code": "US",
            "telephone_number": "740-420-3000",
            "fax_number": "740-420-3009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLATUNDE",
        "first_name": "IGBAGBOYEMI",
        "middle_name": "TEMIDAYO",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "88536",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.134246",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.fam.med.circleville@adena.medicity.net",
            "affiliation": "N",
            "address_1": "140 Morris Rd",
            "city": "Circleville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431131362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.