Individual provider Active NPI

Funmilayo Oladun

  • Case Manager/Care Coordinator
  • Desoto, TX
National Provider Identifier
1104051580
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
613 Garden Brook LN
Desoto, TX 75115-5547
Phone
(214) 205-3602
NPI assigned
May 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

613 Garden Brook LN
Desoto, TX 75115-5547

Mailing address

613 Garden Brook LN
Desoto, TX 75115-5547
Phone (214) 205-3602

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1104051580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 GARDEN BROOK LN",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751155547",
            "telephone_number": "214-205-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 GARDEN BROOK LN",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751155547",
            "telephone_number": "214-205-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLADUN",
        "first_name": "FUNMILAYO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.