Individual provider Active NPI

Kikelomo Idowu Togun, M.D.

  • Pediatrics Physician
  • Shreveport, LA
National Provider Identifier
1124084512
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
12464R Issued in LA
Practice address
214 W 70TH St
Shreveport, LA 71106-3751
Phone
(318) 869-2181
Fax
(318) 869-1730
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 12464R LA Primary

Addresses

Primary practice location

214 W 70TH St
Shreveport, LA 71106-3751

Mailing address

214 W 70TH St
#104
Shreveport, LA 71106-3700
Phone (318) 869-2181

Other identifiers 1

IdentifierTypeStateIssuer
1535915MedicaidLA

Other names 1

  • Dr. Kikelomo Idowu Togun Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20120411000208 LA Practitioner - Pediatric Medicine 1850552316 Practice locations: Shreveport, LA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12464RLAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124084512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 W 70TH ST",
            "address_2": "#104",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711063700",
            "telephone_number": "318-869-2181",
            "fax_number": "318-869-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 W 70TH ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711063751",
            "telephone_number": "318-869-2181",
            "fax_number": "318-869-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOGUN",
        "first_name": "KIKELOMO",
        "middle_name": "IDOWU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "12464R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1535915",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIKELOMO",
            "last_name": "TOGUN",
            "middle_name": "IDOWU",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.