Individual provider Active NPI

Funmilola Aina Sodunke

  • Clinical Neuropsychologist
  • Columbia, MO
National Provider Identifier
1235925512
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
501 Clark Hall FL 5
Columbia, MO 65211-4410
Phone
(573) 882-1561
NPI assigned
Apr 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X Primary

Addresses

Primary practice location

501 Clark Hall FL 5
Columbia, MO 65211-4410

Mailing address

501 Clark Hall FL 5
Columbia, MO 65211-4410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250611004067 PA Practitioner - Clinical Psychologist 2264942846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

4310 Londonderry Rd
Suite 202
Harrisburg, PA 17109-5329
Phone (717) 791-2520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Jul 1, 2025 Accepting new patients
Pinnacle Health Medical Services CurrentSince Jul 1, 2025 Accepting new patients

Locations

4310 Londonderry Rd
Ste 202
Harrisburg, PA 17109
Phone (717) 920-4360

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

4310 Londonderry Rd
Ste 209
Harrisburg, PA 17109
Phone (717) 540-1944

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": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1235925512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 CLARK HALL FL 5",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652114410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CLARK HALL FL 5",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652114410",
            "telephone_number": "573-882-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODUNKE",
        "first_name": "FUNMILOLA",
        "middle_name": "AINA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.