Adebukola Ajagunna
Individual provider Active NPI Pediatrics Physician · Hopkinsville, KY
NPI 1215468541 · NPPES record last updated Jul 23, 2025
Key facts
- NPI
- 1215468541
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 60519 (TN)
- Practice address
- 4235 Fort Campbell Blvd
Hopkinsville, KY 42240-9339 - Phone
- (270) 885-8445
- Fax
- (270) 886-9106
- NPI assigned
- Mar 27, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Vanderbilt Integrated Providers LLC
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200730003891 | TN | Practitioner - Pediatric Medicine | 3375968894 | Reassigns benefits to 1 organization |
| I20220712000838 | KY | Practitioner - Pediatric Medicine | 3375968894 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vanderbilt Integrated Providers, LLC | Pediatrics | Current |
Accepting new patients |
| Vanderbilt Integrated Providers, LLC | Current |
Accepting new patients |
Locations
4235 Fort Campbell Blvd
Hopkinsville, KY 42240
Phone (270) 560-0075
1616 W Main St
Ste 201
Lebanon, TN 37087
Phone (615) 443-6834
1616 W Main St
Ste 102
Lebanon, TN 37087
Phone (615) 453-7454
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
- aajagunna637565@direct.vumc.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 56663 | KY | |
| Pediatrics Physician | 208000000X | 60519 | TN | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100816390 | Medicaid | KY | |
| Q055938 | Medicaid | TN |
Other providers in Hopkinsville, KY
- Adonai Chiropractic Inc
- Adonai Chiropractic LLC
- Advanced Home Medical Inc
- Aesthetic Associates & Women'S Health LLC
- Air Evac EMS Inc
- Denise Hillis Alexander
- Kristen Alexander
- Ahsan Ali
- Sarah Allemon
- Barry Allen
All providers in Hopkinsville, KY · Pediatrics Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.