Simon Olalekan Okewole, D.O.

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

2572 Issued in TN

Practice address

17 Centre Plaza Dr
Jackson, TN 38305-2862

Phone

(731) 512-0104

Fax

(731) 668-7388

NPI assigned

Apr 22, 2008

Last updated

Oct 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Internal MedicineAlso: Cardiovascular Disease (Cardiology)

Education

Philadelphia College of Osteopathic Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Delta Clinics PLCGroup PAC ID 5193022994, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Extendicare Home Health of West TN Home health agency, Dyersburg, TN, CCN 447284
• Volunteer Home Care Home health agency, Humboldt, TN, CCN 447557
• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
• Dyersburg Regional Medical Center Hospital, Dyersburg, TN, CCN 440072
• Hardin Medical Center Hospital, Savannah, TN, CCN 440109
• Baptist Memorial Hospital Union City Hospital, Union City, TN, CCN 440130
• Baptist Memorial Hospital - Carroll County Hospital, Huntingdon, TN, CCN 440016

Merit-based Incentive Payment System (MIPS)

Final score

89.78 of 100Reported as group

Quality

79.9

Improvement activities

40

Cost

80.29

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14260/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-usa.unify.chbase.com/org/lauderd-6f671ec9
• Direct secure messaging: simonokewole@hvcwtn.allscriptsdirect.net
• Direct secure messaging: sokewole61312@direct.bmhcc.org

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.

• Delta Clinics, PLC

  dba Heart & Vascular Center of West TN

  • Cardiovascular Disease Physician
  • Lexington, TN
  • NPI 1396033379
  Medicare reassignment Care Compare group NPD
• Lauderdale Community Hospital LLC

  dba Lauderdale Community Hospital

  • Emergency Care Clinic/Center
  • Ripley, TN
  • NPI 1962034272
  Medicare reassignment NPD
• West Tennessee Medical Group Inc

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1053615955
  Medicare reassignment NPD
• Delta Clinics, P.L.C.

  • Family Nurse Practitioner
  • Jackson, TN
  • NPI 1578004453
  NPD
• Lauderdale Community Hospital LLC

  dba Lauderdale Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Ripley, TN
  • NPI 1356973663
  NPD
• Lauderdale Community Hospital LLC

  dba Lauderdale Community Hospital

  • Critical Access Hospital
  • Ripley, TN
  • NPI 1376175687
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital- Union City Inc

  • General Acute Care Hospital
  • Union City, TN
  • NPI 1114981768
  Care Compare affiliation
• Baptist Memorial Hospital-Huntingdon

  dba Baptist Memorial Hospital - Carroll County

  • General Acute Care Hospital
  • Huntingdon, TN
  • NPI 1710941356
  Care Compare affiliation
• Dyersburg Health

  dba Dyersburg Employee Pharmacy

  • Community/Retail Pharmacy
  • Dyersburg, TN
  • NPI 1043282338

  Hospital

  Care Compare affiliation
• Hardin County General Hospital

  dba Hardin Medical Center

  • General Acute Care Hospital
  • Savannah, TN
  • NPI 1699754812
  Care Compare affiliation
• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation
• Lifeline of West Tennessee, LLC

  dba Extendicare Home Health of West Tennessee

  • Home Health Agency
  • Dyersburg, TN
  • NPI 1821288572
  Care Compare affiliation
• Volunteer Home Care, Inc.

  • Home Health Agency
  • Humboldt, TN
  • NPI 1659320190
  Care Compare affiliation

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1205000296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CENTRE PLAZA DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052862",
            "telephone_number": "731-512-0104",
            "fax_number": "731-668-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CENTRE PLAZA DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052862",
            "telephone_number": "731-512-0104",
            "fax_number": "731-668-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEWOLE",
        "first_name": "SIMON",
        "middle_name": "OLALEKAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-22",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB08388000",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "2572",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TN",
            "license": "2572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396033379",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2572",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "simonokewole@hvcwtn.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "17 Centre Plaza Dr",
            "city": "Jackson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "383052862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelly K Odum, LCSW
• Francis Fensi Ofori, MD
• Ogi WT JV LLC (Skyline Endoscopy of West Tennessee)
• Derick Ogude, MD
• Chantel Okewole, PSY.D.
• Chisom C Okpara
• Kyona Olatunji, NP
• Old Folks Mission Center,Inc. (Mission Convalescent Home)
• Aleruchi Oleru, MD
• Chima O Oleru, MD

• Clinical Cardiac Electrophysiology Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Clinical Cardiac Electrophysiology Physician in Tennessee

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