Active NPI
Adetokunbo Adetutu Ibikunle, MS OTR L
- Occupational Therapist
- Wynnewood, PA
National Provider Identifier
1093837288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC009438
- Practice address
- 300 Fairhill Road
Wynnewood, PA 19096-1804 - Phone
- (610) 649-3255
- Fax
- (610) 649-2289
- NPI assigned
- Apr 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OC009438 | PA | Primary |
Addresses
Primary practice location
300 Fairhill Road
Wynnewood, PA 19096-1804
Mailing address
300 Fairhill Road
Wynnewood, PA 19096-1804
Phone (610) 649-3255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OC009438 | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093837288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 FAIRHILL ROAD",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190961804",
"telephone_number": "610-649-3255",
"fax_number": "610-649-2289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 FAIRHILL ROAD",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190961804",
"telephone_number": "610-649-3255",
"fax_number": "610-649-2289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBIKUNLE",
"first_name": "ADETOKUNBO",
"middle_name": "ADETUTU",
"name_prefix": "Mrs.",
"credential": "MS OTR L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC009438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wynnewood, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.