Constance Olatidoye, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

9901275 Issued in NC

Practice address

1414 S 42ND St
Wilmington, NC 28403-6818

Phone

(910) 350-1330

Fax

(910) 350-1330

NPI assigned

Dec 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Specialty

Psychiatry

Education

University of North Carolina at Chapel Hill School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Dimension Group, LLCGroup PAC ID 0547337123, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Dimension Group, LLC

  • Community/Behavioral Health Agency
  • Rose Hill, NC
  • NPI 1912032475
  Medicare reassignment Care Compare group NPD Authorized official
• New Dimension Group

  • Community/Behavioral Health Agency
  • Rose Hill, NC
  • NPI 1447551965
  NPD (past) Authorized official
• New Dimension Group

  • Psychiatry Physician
  • Rose Hill, NC
  • NPI 1700031788
  NPD (past) Authorized official

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346300332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3743",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284060743",
            "telephone_number": "910-350-1330",
            "fax_number": "910-350-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S 42ND ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036818",
            "telephone_number": "910-350-1330",
            "fax_number": "910-350-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLATIDOYE",
        "first_name": "CONSTANCE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "9901275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891375J",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Ogden, OTR
• Charles Ogiba, MSW, LCSW
• Richard Louis Ogle, PH.D.
• Patrick John Ogrin
• Babatunde Adewale Olatidoye, MD
• Jane S Old, CNS
• Hannah Olds
• Oleander Chiropractic
• Olive Branch Counseling, PLLC
• Olive Branch Speech and Language Services, PC

• Psychiatry Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.