Individual provider Active NPI

Bolanle O Onime, NP

  • Family Nurse Practitioner
  • Lumberton, NC
National Provider Identifier
1386201473
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5011733 Issued in NC
Practice address
2936 N Elm St Ste 102
Lumberton, NC 28358-2981
Phone
(910) 671-6619
Fax
(910) 608-0487
NPI assigned
May 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 219941 NC
Family Nurse Practitioner 363LF0000X 5011733 NC Primary

Addresses

Primary practice location

2936 N Elm St Ste 102
Lumberton, NC 28358-2981

Mailing address

2936 N Elm St Ste 102
Lumberton, NC 28358-2981

Other identifiers 1

IdentifierTypeStateIssuer
30428812OtherNCDRIVER LICENSE

Other names 1

  • Bolanle Olabisi Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bonime810978@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190911001354 NC Practitioner - Nurse Practitioner 3274862503 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Mar 19, 2023 Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

Interoperability endpoints

  • Direct secure messaging: bonime810978@direct.unc.nchie.net

Organizations & group practices 1

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": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1386201473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2936 N ELM ST STE 102",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2936 N ELM ST STE 102",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582981",
            "telephone_number": "910-671-6619",
            "fax_number": "910-608-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONIME",
        "first_name": "BOLANLE",
        "middle_name": "O",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "219941",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5011733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "30428812",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bonime810978@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BOLANLE",
            "last_name": "OLABISI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.