Active NPI
Kolawole Adedokun
- Licensed Practical Nurse
- New York, NY
National Provider Identifier
1366091332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 331766-1
- Practice address
- 311 W 35TH St
New York, NY 10001-1701 - Phone
- (212) 736-5900
- NPI assigned
- Sep 11, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 331766-1 | NY | Primary |
Addresses
Primary practice location
311 W 35TH St
New York, NY 10001-1701
Mailing address
311 W 35TH St
New York, NY 10001-1701
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133952613 | Medicaid | NY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 331766-1 | NY | MD | Orthopedic Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568160000000",
"number": "1366091332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 W 35TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100011701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 W 35TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100011701",
"telephone_number": "212-736-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEDOKUN",
"first_name": "KOLAWOLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-11",
"last_updated": "2019-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "331766-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133952613",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.