Individual provider Active NPI

Adebayo Ebenezer Fatoki

  • Nurse Practitioner
  • Brownsburg, IN
National Provider Identifier
1356032593
Registry record updated Nov 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71013946A Issued in IN
Practice address
6972 Sablecliff Way
Brownsburg, IN 46112-7022
Phone
(317) 440-5342
NPI assigned
May 18, 2023
Last updated
Nov 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71013946A IN Primary

Addresses

Primary practice location

6972 Sablecliff Way
Brownsburg, IN 46112-7022

Mailing address

6972 Sablecliff Way
Brownsburg, IN 46112-7022
Phone (317) 440-5342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417000504 IN Practitioner - Nurse Practitioner 6305361817 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71013946AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Olive Tree Medical Services LLC Nurse Practitioner CurrentSince Feb 17, 2025 Accepting new patients

Locations

6865 Parkdale Pl
Indianapolis, IN 46254
Phone (317) 297-7773

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763164800000",
    "number": "1356032593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6972 SABLECLIFF WAY",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461127022",
            "telephone_number": "317-440-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6972 SABLECLIFF WAY",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461127022",
            "telephone_number": "317-440-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATOKI",
        "first_name": "ADEBAYO",
        "middle_name": "EBENEZER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-18",
        "last_updated": "2025-11-15",
        "certification_date": "2025-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71013946A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsburg, IN

Sources for this page

Verify at the official NPI Registry.