Individual provider Active NPI

Omolara Layeni, PA-C

  • Physician Assistant
  • Pineville, NC
National Provider Identifier
1063766848
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001005636 Issued in NC
Practice address
9101 Pineville Matthews Rd Ste C4
Pineville, NC 28134-8840
Phone
(980) 202-7920
NPI assigned
Nov 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001005636 NC Primary

Addresses

Primary practice location

9101 Pineville Matthews Rd Ste C4
Pineville, NC 28134-8840

Mailing address

9628 Rea Rd
Charlotte, NC 28277-6697
Phone (704) 542-5072

Other practice location 1

9628 Rea Rd
Charlotte, NC 28277-6697
Phone (704) 542-5072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151202002851 NC Practitioner - Physician Assistant 8325280571 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
NH-CL Clinics LLCGroup PAC ID 6305262692, 82 clinicians

Practice addresses (Care Compare)

15015 Lancaster Hwy
Suite 200
Charlotte, NC 28277-2010
Phone (980) 202-7980

2810 Maplewood Ave
Winston Salem, NC 27103-4138
Phone (336) 860-6194

500 Pineview Dr
Suite 205
Kernersville, NC 27284-3814
Phone (336) 329-3295

9101 Pineville Matthews Rd
Suite C4
Pineville, NC 28134-8840
Phone (980) 202-7920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Potomac Physicians PA Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: olayeni281163@direct.novanthealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1063766848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9628 REA RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776697",
            "telephone_number": "704-542-5072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 PINEVILLE MATTHEWS RD STE C4",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "281348840",
            "telephone_number": "980-202-7920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9628 Rea Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282776697",
            "country_code": "US",
            "telephone_number": "704-542-5072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAYENI",
        "first_name": "OMOLARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001005636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, NC

Sources for this page

Verify at the official NPI Registry.