Individual provider Active NPI

Adebayo T Olatunji, NP

  • Family Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1376054718
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10170653 Issued in TX
Practice address
306 E Randol Mill Rd Ste 136
Arlington, TX 76011-5841
Phone
(817) 697-4619
Fax
(817) 984-8544
NPI assigned
Oct 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F10170653 TX Primary

Addresses

Primary practice location

306 E Randol Mill Rd Ste 136
Arlington, TX 76011-5841

Mailing address

1401 Bell Ranch Cir
Euless, TX 76040-4974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180209000079 TX Practitioner - Nurse Practitioner 0244590388 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

306 E Randol Mill Rd
Suite 136
Arlington, TX 76011-5841
Phone (817) 697-4619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F10170653TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arlington Progressive Health Center Inc. Family CurrentSince Jul 18, 2022 Accepting new patients
Fort Worth Internal Medicine PA CurrentSince Jan 17, 2018 Accepting new patients
Odette Louise Campbell MD PA CurrentSince May 1, 2025 Accepting new patients

Locations

306 E Randol Mill Rd
Ste 136
Arlington, TX 76011
Phone (817) 224-2292

607 E Abram St
Ste 14
Arlington, TX 76010
Phone (682) 597-5097

650 Saint Louis Ave
Fort Worth, TX 76104
Phone (817) 332-4004

5072 W Plano Pkwy
Ste 220
Plano, TX 75093
Phone (469) 671-0900

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.

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1376054718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 BELL RANCH CIR",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760404974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E RANDOL MILL RD STE 136",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760115841",
            "telephone_number": "817-697-4619",
            "fax_number": "817-984-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLATUNJI",
        "first_name": "ADEBAYO",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-12",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F10170653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.