Individual provider Active NPI

Adeyimika Omololu, MD

  • Family Medicine Physician
  • Visalia, CA
National Provider Identifier
1265878441
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
144031 Issued in CA
Practice address
401 E School Ave
Visalia, CA 93291-5032
Phone
(877) 960-3426
NPI assigned
May 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 144031 CA Primary

Addresses

Primary practice location

401 E School Ave
Visalia, CA 93291-5032

Mailing address

305 E Center Ave
Visalia, CA 93291-6331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 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
I20161128000430 CA Practitioner - Family Practice 7315171329 Reassigns benefits to 1 organization
I20220920001619 AZ Practitioner - Family Practice 7315171329 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
144031CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network CurrentSince Oct 12, 2016 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Primary Care Walk-in Medical Clinic Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince Oct 12, 2016 Accepting new patients
Family Healthcare Network Current Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients

Locations

16605 E Palisades Blvd
Ste 150
Fountain Hls, AZ 85268
Phone (480) 837-4300

33025 Road 159
Ivanhoe, CA 93235
Phone (559) 798-1877

12586 Avenue 408
Orosi, CA 93647
Phone (559) 528-2804

1107 W Poplar Ave
Porterville, CA 93257
Phone (559) 781-7242

9416 Road 238
Terra Bella, CA 93270
Phone (559) 741-4500

401 E School Ave
Visalia, CA 93291
Phone (559) 741-4356

31180 Road 72
Visalia, CA 93291
Phone (559) 651-2301

501 N Bridge St
Visalia, CA 93291
Phone (559) 734-1939

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

400 E Oak Ave
Visalia, CA 93291
Phone (559) 741-4500

201 E Lakeview Ave
Woodlake, CA 93286
Phone (559) 564-0100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA

Organizations & group practices 10

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": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1265878441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E CENTER AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E SCHOOL AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915032",
            "telephone_number": "877-960-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOLOLU",
        "first_name": "ADEYIMIKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-15",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "144031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.