Olugbemi O Elegbe, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

Q3177 Issued in TX

Practice address

501 W River St
Ozark, AR 72949-3127

Phone

(479) 667-4138

Fax

(479) 667-9778

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Concord Medical Group, PLLC

  • Hospitalist Physician
  • Deridder, LA
  • NPI 1972906758
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1245440304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 PARK AVE",
            "address_2": "STE. 304",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729031478",
            "telephone_number": "479-478-6174",
            "fax_number": "479-314-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W RIVER ST",
            "city": "OZARK",
            "state": "AR",
            "postal_code": "729493127",
            "telephone_number": "479-667-4138",
            "fax_number": "479-667-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELEGBE",
        "first_name": "OLUGBEMI",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q3177",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-6310",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07833",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jim Howard Curlin III, D.D.S.
• Stacy Elaine Darr, PT
• Duggar Family Practice
• Duggar Family Practice LLC (Duggar Family Practice)
• Sarah Edwards, APRN
• Kemis Irene Enright, P.T.A.
• Fayetteville Vamc
• Yvonia Jean Finley, APN
• Theresa D Fontaine, NP
• Amber Fortenberry

• Emergency Medicine Physician in Ozark, AR
• Providers in Ozark, AR by specialty
• Emergency Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.