Amanda Ebun Olagunju, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0102207707 Issued in VA

Practice address

48 Newmarket SQ
Newport News, VA 23605-2721

Phone

(757) 825-8030

Fax

(757) 847-9149

NPI assigned

Jun 30, 2016

Last updated

May 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• PMR Virginia Holding, LLC

  dba Jencare Senior Medical Centers of Virginia

  • Specialist
  • Miami Gardens, FL
  • NPI 1083167001

  VA

  Medicare reassignment NPD
• Jencare Neighborhood Medical East Richmond, LLC

  dba JenCare Neighborhood MedicalEast Richmond

  • Internal Medicine Physician
  • Richmond, VA
  • NPI 1891089454
  NPD (past)

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1083065064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 NEWMARKET SQ",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236052721",
            "telephone_number": "757-825-8030",
            "fax_number": "757-847-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 NEWMARKET SQ",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236052721",
            "telephone_number": "757-825-8030",
            "fax_number": "757-847-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAGUNJU",
        "first_name": "AMANDA",
        "middle_name": "EBUN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "7732",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102207707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bandetra Oglesby-Confron
• Babatunde Ogunjulugbe
• Richard Ohagan, D.O.
• Oluwafemi Abiola Ojekunle
• Adeshola Okuwoga, CSFA
• Oyejoke Temilola Olaoye-Adejayan, PHARMD, MPH
• Old Dominion Rehabilitation and Nursing LLC (Old Dominion Rehabilitation and Nursing)
• William L Old III, MD
• Cameron Lauritz Oldham
• Stephen Olesko, PHARM.D.

• Family Medicine Physician in Newport News, VA
• Providers in Newport News, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.