Individual provider Active NPI

Omolara Ajayi, PT

  • Physical Therapist
  • Richardson, TX
National Provider Identifier
1356045108
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
600 W Arapaho Rd
Richardson, TX 75080-4423
Phone
(469) 549-3543
NPI assigned
Mar 27, 2023
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

600 W Arapaho Rd
Richardson, TX 75080-4423

Mailing address

266 Community Dr
Lavon, TX 75166-4740
Phone (682) 203-8590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230427000201 TX Practitioner - Physical Therapist in Private Practice 8729443759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

600 W Arapaho Rd
Richardson, TX 75080-4423
Phone (469) 712-8148

700 E State Hwy 114
Southlake, TX 76092-5236
Phone (682) 310-0092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1229715TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Feb 28, 2023 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Aug 4, 2023 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Aug 4, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Feb 28, 2023 Accepting new patients
Aegis Group Practice LLC Physical Therapist Current Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

8100 Precinct Line Rd
Colleyville, TX 76034
Phone (682) 244-4317

800 Whitley Rd
Keller, TX 76248
Phone (817) 357-7181

265 Plateau Dr
McKinney, TX 75069
Phone (512) 277-6405

700 E State Highway 114
Southlake, TX 76092
Phone (682) 305-0657

Organizations & group practices 5

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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1356045108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 COMMUNITY DR",
            "city": "LAVON",
            "state": "TX",
            "postal_code": "751664740",
            "telephone_number": "682-203-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W ARAPAHO RD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750804423",
            "telephone_number": "469-549-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAYI",
        "first_name": "OMOLARA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.