Individual provider Active NPI

Olajide A Wilkerson

  • Prosthetics Case Management
  • Miami, FL
National Provider Identifier
1356805642
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
Practice address
540 NW 165TH Street Rd Ste 109
Miami, FL 33169-6304
Phone
(954) 471-5170
NPI assigned
Jan 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X Primary

Addresses

Primary practice location

540 NW 165TH Street Rd Ste 109
Miami, FL 33169-6304

Mailing address

2728 Davie Blvd Ste 73
Fort Lauderdale, FL 33312-2927
Phone (954) 471-5170

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

Practice roles

OrganizationSpecialtyStatusNew patients
Illusion Hair Industries LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1356805642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 DAVIE BLVD STE 73",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333122927",
            "telephone_number": "954-471-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 NW 165TH STREET RD STE 109",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331696304",
            "telephone_number": "954-471-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "OLAJIDE",
        "middle_name": "A",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.