Individual provider Active NPI

Adebukola Ajagunna

  • Pediatrics Physician
  • Hopkinsville, KY
National Provider Identifier
1215468541
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
60519 Issued in TN
Practice address
4235 Fort Campbell Blvd
Hopkinsville, KY 42240-9339
Phone
(270) 885-8445
Fax
(270) 886-9106
NPI assigned
Mar 27, 2017
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 56663 KY
Pediatrics Physician 208000000X 60519 TN Primary

Addresses

Primary practice location

4235 Fort Campbell Blvd
Hopkinsville, KY 42240-9339

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200730003891 TN Practitioner - Pediatric Medicine 3375968894 Reassigns benefits to 1 organization
I20220712000838 KY Practitioner - Pediatric Medicine 3375968894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1616 W Main St
Suite 102
Lebanon, TN 37087-3191
Phone (615) 453-7454

4235 Fort Campbell Blvd
Hopkinsville, KY 42240-9339
Phone (270) 885-8445

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt Integrated Providers, LLC CurrentSince Jul 1, 2022 Accepting new patients
Vanderbilt Integrated Providers, LLC Pediatrics CurrentSince Jul 1, 2022 Accepting new patients

Locations

4235 Fort Campbell Blvd
Hopkinsville, KY 42240
Phone (270) 560-0075

1616 W Main St
Ste 102
Lebanon, TN 37087
Phone (615) 453-7454

1616 W Main St
Ste 201
Lebanon, TN 37087
Phone (615) 421-4626

1400 Willow Dr
Manchester, TN 37355
Phone (931) 409-2194

3841 Green Hills Village Dr
Ste 200
Nashville, TN 37215
Phone (615) 322-6842

Interoperability endpoints

  • Direct secure messaging: aajagunna637565@direct.vumc.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1215468541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691",
            "fax_number": "615-322-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 FORT CAMPBELL BLVD",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422409339",
            "telephone_number": "270-885-8445",
            "fax_number": "270-886-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAGUNNA",
        "first_name": "ADEBUKOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "56663",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "60519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinsville, KY

Sources for this page

Verify at the official NPI Registry.