Individual provider Active NPI

Raifu Adewale Olorunfemi, P.T., M.S.

  • Physical Therapist
  • Ocala, FL
National Provider Identifier
1235167974
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12870 Issued in FL
Practice address
7380SW 60TH Ave
Ste 3
Ocala, FL 34476-6467
Phone
(352) 840-0004
Fax
(352) 873-2631
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT12870 FL Primary

Addresses

Primary practice location

7380SW 60TH Ave
Ste 3
Ocala, FL 34476-6467

Mailing address

7380 SW 60TH Ave
Ste 3
Ocala, FL 34476-6467
Phone (352) 840-0004

Other identifiers 1

IdentifierTypeStateIssuer
884834300MedicaidFL

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
Master of Science

State licenses

LicenseStateTypeSpecialty
PT12870FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Therapist & Rehabilitative Group, Inc. Physical Therapist Past 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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1235167974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7380 SW 60TH AVE",
            "address_2": "STE 3",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344766467",
            "telephone_number": "352-840-0004",
            "fax_number": "352-873-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7380SW 60TH AVE",
            "address_2": "STE 3",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344766467",
            "telephone_number": "352-840-0004",
            "fax_number": "352-873-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLORUNFEMI",
        "first_name": "RAIFU",
        "middle_name": "ADEWALE",
        "name_prefix": "Mr.",
        "credential": "P.T., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT12870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "884834300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.