Active NPI
Stridewell Healthcare PLLC
- Psychiatry Physician
- Charlotte, NC
National Provider Identifier
1053987552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- STRIDEWELL HEALTHCARE PLLC
- Practice address
- 10801 Johnston Rd Ste 207
Charlotte, NC 28226-0920 - Phone
- (980) 349-8978
- Fax
- (870) 408-3957
- NPI assigned
- Jun 3, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Bamidele A Ajayi, MD
- Title
- Owner
- Phone
- (870) 702-1465
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary | ||
| Child & Adolescent Psychiatry Physician | 2084P0804X | |||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X |
Addresses
Primary practice location
10801 Johnston Rd Ste 207
Charlotte, NC 28226-0920
Mailing address
5710 El Campo CT
Charlotte, NC 28277-1842
Phone (870) 702-1465
National Provider Directory
National Provider DirectoryLocations
10801 Johnston Rd
Ste 207
Charlotte, NC 28226
Phone (980) 349-8978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622678400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1694563200000",
"number": "1053987552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5710 EL CAMPO CT",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282771842",
"telephone_number": "870-702-1465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10801 JOHNSTON RD STE 207",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282260920",
"telephone_number": "980-349-8978",
"fax_number": "870-408-3957"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STRIDEWELL HEALTHCARE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-03",
"last_updated": "2023-09-13",
"certification_date": "2023-04-11",
"status": "A",
"authorized_official_last_name": "AJAYI",
"authorized_official_first_name": "BAMIDELE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "870-702-1465",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.