Individual provider Active NPI

Adebisi Mary Fagbohun, MD

  • Family Medicine Physician
  • Richmond, IN
National Provider Identifier
1366040065
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01091276A Issued in IN
Practice address
1100 Reid Pkwy
Richmond, IN 47374-1157
Phone
(765) 983-3000
NPI assigned
Oct 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01091276A IN Primary

Addresses

Primary practice location

1100 Reid Pkwy
Richmond, IN 47374-1157

Mailing address

1100 Reid Pkwy
Medical Staff Services
Richmond, IN 47374-1157
Phone (765) 935-8808

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aadeyemi428571@ReidHealth.direct-ci.com Health Information Exchange (HIE) Reid Physician Associates, Inc.

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20231108002389 IN Practitioner - Family PracticePractitioner - Hospitalist 6204246192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians

Practice addresses (Care Compare)

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 983-3122

Hospital & facility affiliations

  • Reid Health Hospital, Richmond, IN, CCN 150048
  • Ascension St Vincent Randolph Hospital, Winchester, IN, CCN 151301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Reid Physician Associates, Inc. CurrentSince Dec 1, 2023 Accepting new patients
Reid Physician Associates, Inc CurrentSince Dec 1, 2023 Accepting new patients
Reid Hospital & Health Care Services, Inc Past Accepting new patients

Locations

1100 Reid Pkwy
Richmond, IN 47374
Phone (765) 983-3000

Interoperability endpoints

  • Direct secure messaging: aadeyemi428571@reidhealth.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1366040065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-935-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-983-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGBOHUN",
        "first_name": "ADEBISI",
        "middle_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01091276A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aadeyemi428571@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1100 Reid Pkwy",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.