NPIMap

Individual provider Active NPI

Adebomi Adeola Omikunle, MD

  • Pediatrics Physician
  • Powell, OH
National Provider Identifier
1205099686
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35091215 Issued in OH
Practice address
55 Clairedan Dr.
Powell, OH 43065
Phone
(614) 888-8989
Fax
(614) 888-8968
NPI assigned
Jul 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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 35091215 OH Primary

Addresses

Primary practice location

55 Clairedan Dr.
Powell, OH 43065

Mailing address

55 Clairedan Dr.
Powell, OH 43065
Phone (614) 888-8989

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 Medicine

State licenses

LicenseStateTypeSpecialty
35091215OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Central Ohio Primary Care Physicians, Inc. Pediatrics Past Accepting new patients
Powell Pediatric Care Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aomikunle19121@copcp.medicity.net

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1205099686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CLAIREDAN DR.",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "43065",
            "telephone_number": "614-888-8989",
            "fax_number": "614-888-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CLAIREDAN DR.",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "43065",
            "telephone_number": "614-888-8989",
            "fax_number": "614-888-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMIKUNLE",
        "first_name": "ADEBOMI",
        "middle_name": "ADEOLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35091215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.