Individual provider Active NPI

Oluwakemi Omotomilayo Ijimakinwa

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1376401687
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71017636A Issued in IN
Practice address
602 N High School Rd
Indianapolis, IN 46214-3694
Phone
(317) 291-1211
NPI assigned
Jan 14, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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 71017636A IN Primary

Addresses

Primary practice location

602 N High School Rd
Indianapolis, IN 46214-3694

Mailing address

602 N High School Rd
Indianapolis, IN 46214-3694
Phone (317) 291-1211

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

LicenseStateTypeSpecialty
71017636AINMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1768348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1376401687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 N HIGH SCHOOL RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462143694",
            "telephone_number": "317-291-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N HIGH SCHOOL RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462143694",
            "telephone_number": "317-291-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IJIMAKINWA",
        "first_name": "OLUWAKEMI",
        "middle_name": "OMOTOMILAYO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71017636A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; 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.