Individual provider Active NPI

Olamigoke David Omotayo

  • Family Nurse Practitioner
  • Greenwood, IN
National Provider Identifier
1396616280
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71016925A Issued in IN
Practice address
821 N State Road 135
Greenwood, IN 46142-1314
Phone
(317) 560-4300
Fax
(317) 530-9084
NPI assigned
Sep 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 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 71016925A IN Primary

Addresses

Primary practice location

821 N State Road 135
Greenwood, IN 46142-1314

Mailing address

821 N State Road 135
Greenwood, IN 46142-1314
Phone (317) 560-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250927000317 IN Practitioner - Nurse Practitioner 0244735371 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians of Indiana LLCGroup PAC ID 4981841780, 76 clinicians

Practice addresses (Care Compare)

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-5000

6021 S Arlington Ave
Indianapolis, IN 46237-3164
Phone (317) 999-9292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71016925AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Indiana, LLC CurrentSince Jan 13, 2026 Accepting new patients
Total Care Family Practice Rick Bobay LLC Family CurrentSince Sep 1, 2025 Accepting new patients
Sound Physicians of Indiana, LLC CurrentSince Jan 13, 2026 Accepting new patients
Total Care Family Practice Rick Bobay LLC Family CurrentSince Sep 1, 2025 Accepting new patients
Transitions Health Network LLC Family Past Accepting new patients

Locations

2516 Waterbridge Way
Evansville, IN 47710
Phone (812) 491-9000

1701 Spring St
Ste B
Jeffersonvlle, IN 47130
Phone (812) 284-2272

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

Organizations & group practices 7

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": "1757894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1396616280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 N STATE ROAD 135",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421314",
            "telephone_number": "317-560-4300",
            "fax_number": "317-530-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N STATE ROAD 135",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421314",
            "telephone_number": "317-560-4300",
            "fax_number": "317-530-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOTAYO",
        "first_name": "OLAMIGOKE",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-15",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71016925A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.