Active NPI
Ola Bidex Ogundiya, PHARMD, RPH
- Pharmacist
- Shreveport, LA
National Provider Identifier
1134624554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.022417
- Practice address
- 3555 Greenwood Rd
Shreveport, LA 71109 - Phone
- (318) 525-0144
- Fax
- (318) 525-0222
- NPI assigned
- Mar 27, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.022417 | LA | Primary |
Addresses
Primary practice location
3555 Greenwood Rd
Shreveport, LA 71109
Mailing address
1733 S Reunion Dr
Shreveport, LA 71118-2250
Phone (773) 708-2305
Other practice location 1
6101 W 70th St
Shreveport, LA 71129-2507
Phone (318) 688-1448
Other practice location 2
6101 W 70th St
Shreveport, LA 71129-2507
Phone (318) 688-1448
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64472 | Other | TX | PHAMD, RPH |
| PST.022417 | Other | LA | PHARMACIST |
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
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.022417 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 3
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": "1522108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555632000000",
"number": "1134624554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1733 S REUNION DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711182250",
"telephone_number": "773-708-2305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3555 GREENWOOD RD",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "71109",
"telephone_number": "318-525-0144",
"fax_number": "318-525-0222"
}
],
"practiceLocations": [
{
"address_1": "6101 W 70th St",
"address_purpose": "LOCATION",
"city": "Shreveport",
"state": "LA",
"postal_code": "711292507",
"country_code": "US",
"telephone_number": "318-688-1448",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6101 W 70th St",
"address_purpose": "LOCATION",
"city": "Shreveport",
"state": "LA",
"postal_code": "711292507",
"country_code": "US",
"telephone_number": "318-688-1448",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OGUNDIYA",
"first_name": "OLA",
"middle_name": "BIDEX",
"credential": "PHARMD, RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-27",
"last_updated": "2019-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.022417",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHAMD, RPH",
"identifier": "64472",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "PST.022417",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.