Organization Active NPI

Stridewell Healthcare PLLC

  • Psychiatry Physician
  • Charlotte, NC
National Provider Identifier
1053987552
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
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

Updated by the provider on Sep 13, 2023

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)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.