Individual provider Active NPI

Adenike S Ogunbanwo, RN

  • Home Health Registered Nurse
  • Brooklyn Park, MN
National Provider Identifier
1205722188
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
2285292 Issued in MN
Practice address
5501 88TH Cres N
Brooklyn Park, MN 55443-3983
Phone
(763) 568-6204
Fax
(612) 444-7501
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 2285292 MN Primary

Addresses

Primary practice location

5501 88TH Cres N
Brooklyn Park, MN 55443-3983

Mailing address

5501 88TH Cres N
Brooklyn Park, MN 55443-3983
Phone (763) 568-6204

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2285292MNMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
El-Lyon LLC CurrentSince Jun 23, 2025 Accepting new patients

Organizations & group practices 1

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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1205722188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 88TH CRES N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554433983",
            "telephone_number": "763-568-6204",
            "fax_number": "612-444-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 88TH CRES N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554433983",
            "telephone_number": "763-568-6204",
            "fax_number": "612-444-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNBANWO",
        "first_name": "ADENIKE",
        "middle_name": "S",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "2285292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.