Active NPI
Oluwatosin A Fadeyi, PHARMD/MBA
- Pharmacist
- Cordova, TN
National Provider Identifier
1295198703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 35423
- Practice address
- 1780 N Germantown Pkwy
Cordova, TN 38016-5030 - Phone
- (901) 756-3902
- NPI assigned
- Apr 1, 2016
- Last updated
- Apr 1, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 35423 | TN | Primary |
| Pharmacist | 183500000X | T12990 | MS | |
| Pharmacist | 183500000X | 0202204865 | VA |
Addresses
Primary practice location
1780 N Germantown Pkwy
Cordova, TN 38016-5030
Mailing address
1780 N Germantown Pkwy
Cordova, TN 38016-5030
Phone (901) 756-3902
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 Business Administration, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T12990 | MS | MD | Pharmacist |
| 0202204865 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459468800000",
"number": "1295198703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1780 N GERMANTOWN PKWY",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380165030",
"telephone_number": "901-756-3902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1780 N GERMANTOWN PKWY",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380165030",
"telephone_number": "901-756-3902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADEYI",
"first_name": "OLUWATOSIN",
"middle_name": "A",
"credential": "PHARMD/MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-01",
"last_updated": "2016-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "35423",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "T12990",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202204865",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
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- Eyemart Express LTD (EyeMart Express)
- Nkiruka C Ezenwa, M.D
- Allegra Vanessa McDonald Fadeyi, PHARMD, CGP
- Lisa Diane Fair, PMHNP-BC
- Fairhaven Holdings, LLC (Fairhaven Treatment Center)
- Fairhaven Treatment Center
- Faith and Hope Healthcare Transportation, LLC
- Faith Specialized Care Services Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.