NPIMap

Individual provider Active NPI

Adeniyi Faruk Koiki, M.D.

  • Emergency Medicine Physician
  • Moulton, AL
National Provider Identifier
1366480774
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
00020062 Issued in AL
Practice address
202 Hospital St
Moulton, AL 35650-1218
Phone
(205) 974-2200
NPI assigned
Jun 4, 2006
Last updated
Oct 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00020062 AL Primary

Addresses

Primary practice location

202 Hospital St
Moulton, AL 35650-1218

Mailing address

5323 Dixieland Rd
Irondale, AL 35210-2914
Phone (205) 915-9451

Other identifiers 2

IdentifierTypeStateIssuer
009987875MedicaidAL
51001137KOIOtherALBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504001027 AL Practitioner - Emergency MedicinePractitioner - Internal Medicine 4385684851 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
Morehouse School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Relias Emergency Medicine Specialists of Hamilton, LLCGroup PAC ID 0547599490, 9 clinicians

Practice addresses (Care Compare)

1256 Military St S
Hamilton, AL 35570-5003
Phone (205) 921-6200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00020062ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Em-I Medical Services PC Emergency Medicine CurrentSince Nov 1, 2015 Accepting new patients
Correct Care, Inc. Emergency Medicine CurrentSince Feb 28, 2012 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Alabama Em I Medical Services PC Emergency Medicine CurrentSince Nov 1, 2015 Accepting new patients
Relias Emergency Medicine Specialists of Hamilton, LLC Emergency Medicine CurrentSince Jul 23, 2019 Accepting new patients
Marion Regional Medical Center, Inc. CurrentSince Apr 22, 2012 Accepting new patients
Marion Regional Medical Center, Inc CurrentSince Apr 22, 2012 Accepting new patients
Southern Medical Group, Inc Emergency Medicine Past Accepting new patients
Paragon Contracting Services LLC Emergency Medicine Past Accepting new patients
Fayette Medical Center Past Accepting new patients

Locations

1256 Military St S
Hamilton, AL 35570
Phone (205) 921-6200

1336 Military St S
Hamilton, AL 35570
Phone (205) 921-0521

201 Avalon Ave
Muscle Shoals, AL 35661
Phone (256) 386-1600

1032 Main St S
Wedowee, AL 36278
Phone (256) 357-2111

229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225

1111 N Causeway Blvd
Mandeville, LA 70471
Phone (985) 249-5600

Interoperability endpoints

  • Direct secure messaging: adeniyikoiki@nmhs.medalliesdirect.net

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1366480774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 DIXIELAND RD",
            "city": "IRONDALE",
            "state": "AL",
            "postal_code": "352102914",
            "telephone_number": "205-915-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 HOSPITAL ST",
            "city": "MOULTON",
            "state": "AL",
            "postal_code": "356501218",
            "telephone_number": "205-974-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOIKI",
        "first_name": "ADENIYI",
        "middle_name": "FARUK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "00020062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009987875",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "51001137KOI",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moulton, AL

Sources for this page

Verify at the official NPI Registry.