Adebola Omolara Ilesanmi, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201969 Issued in NC

Practice address

601 S Martin Luther King Jr Dr
Room 244
Winston Salem, NC 27110-0001

Phone

(336) 750-3300

Fax

(336) 750-3303

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Winston Salem State University, a. H. Ray Student Health Service

  • Student Health Clinic/Center
  • Winston Salem, NC
  • NPI 1376716811
  NPD (past)
• Winston-Salem State University

  • Student Health Clinic/Center
  • Winston Salem, NC
  • NPI 1851713374

  Family

  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231804800000",
    "number": "1285784033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SOUTH M.L.K. JR. DRIVE",
            "address_2": "ROOM 244",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271100001",
            "telephone_number": "336-750-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S MARTIN LUTHER KING JR DR",
            "address_2": "ROOM 244",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271100001",
            "telephone_number": "336-750-3300",
            "fax_number": "336-750-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILESANMI",
        "first_name": "ADEBOLA",
        "middle_name": "OMOLARA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2009-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore Osarumwense Igbinigie, MD
• Chioma Igboegwu, PHD, LCAS-A
• Fulfilled Iwosa Ighalo, MD
• Emmanuelar Onyinyechukwu Igweonu-Nwakile, MD
• Obinna Ikwechegh, MD
• Illumii
• Imani Enterprises Dba a L Nursing Home Care Agency (AL Nursing Home Care Agency)
• Imani Home Care Service, LLC (Imani Home Care Service)
• Lauren W Imboden, PA
• Ryan Imel, PHARMD

• Family Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; 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.