Individual provider Active NPI

Jacqueline Nwando Olayiwola, MD

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1073510103
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35137342 Issued in OH
Practice address
543 Taylor Ave FL 2
Columbus, OH 43203-1278
Phone
(614) 688-6490
Fax
(614) 688-6491
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35137342 OH Primary

Addresses

Primary practice location

543 Taylor Ave FL 2
Columbus, OH 43203-1278

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 688-6490

Other identifiers 1

IdentifierTypeStateIssuer
004236346MedicaidCT

Other names 1

  • Jacqueline Nwando Onyejekwe Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191021002891 OH Practitioner - Family Practice 6507851201 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35137342OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of Ohio Family Health Centers Current Accepting new patients
Heart of Ohio Family Health Centers CurrentSince Jun 14, 2024 Accepting new patients
Heart of Ohio Family Health Centers CurrentSince Jun 14, 2024 Accepting new patients
Carbon Health Primary Care of California PC Family Medicine PastSince Jul 20, 2025 Accepting new patients

Locations

3601 Gender Rd
Canal Wnchstr, OH 43110
Phone (614) 235-5555

2365 Innis Rd
Columbus, OH 43224
Phone (614) 235-5555

5000 E Main St
Whitehall, OH 43213
Phone (614) 235-5555

Interoperability endpoints

  • Direct secure messaging: nolayiwola756291@direct.osumc.edu

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1073510103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-688-6490",
            "fax_number": "614-688-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 TAYLOR AVE FL 2",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432031278",
            "telephone_number": "614-688-6490",
            "fax_number": "614-688-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAYIWOLA",
        "first_name": "JACQUELINE",
        "middle_name": "NWANDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35137342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236346",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "ONYEJEKWE",
            "middle_name": "NWANDO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.