NPIMap

Individual provider Active NPI

David Ajibade, MD

  • Orthopaedic Surgery Physician
  • Orangeburg, SC
National Provider Identifier
1407050248
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
35229 Issued in SC
Practice address
1175 Cook Rd Ste 215
Orangeburg, SC 29118-8201
Phone
(803) 395-3837
NPI assigned
Jun 14, 2007
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2017-01344 NC
Orthopaedic Surgery Physician 207X00000X 35229 SC Primary

Addresses

Primary practice location

1175 Cook Rd Ste 215
Orangeburg, SC 29118-8201

Mailing address

PO Box 23321
New York, NY 10087-3321
Phone (843) 792-6200

Other practice location 1

14508 James B White Hwy S
Tabor City, NC 28463-8358
Phone (910) 653-7000

Other practice location 2

701 Jefferson St
Whiteville, NC 28472-3704
Phone (910) 641-8625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, IL, MI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130311000159 SC Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 4587819958 Reassigns benefits to 1 organization
I20160906000905 IL Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 4587819958 Reassigns benefits to 1 organization
I20161010000760 MI Practitioner - Orthopedic Surgery 4587819958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
University of Texas Medical School at San Antonio, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone (803) 395-3400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement15
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017-01344NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Aug 25, 2016 Accepting new patients
Musc Community Physicians CurrentSince Mar 1, 2023 Accepting new patients
Mecosta County Medical Center CurrentSince Sep 7, 2016 Accepting new patients
Mecosta County Medical Center CurrentSince Sep 7, 2016 Accepting new patients
Mecosta County Medical Center Current Accepting new patients
Musc Community Physicians Orthopaedic Surgery CurrentSince Mar 1, 2023 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients
Columbus Regional Health Network Past Accepting new patients
Columbus Regional Health Network Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2350 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-2200

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

605 Oak St
Big Rapids, MI 49307
Phone (231) 592-1079

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1175 Cook Rd
Orangeburg, SC 29118
Phone (803) 395-2579

1175 Cook Rd
Ste 215
Orangeburg, SC 29118
Phone (803) 395-3837

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

Interoperability endpoints

  • Direct secure messaging: dajibade@crhn.cernerdirect.com
  • Direct secure messaging: dajibade442679@direct.musc.edu

Organizations & group practices 9

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 8

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1407050248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23321",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873321",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 COOK RD STE 215",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291188201",
            "telephone_number": "803-395-3837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14508 James B White Hwy S",
            "address_purpose": "LOCATION",
            "city": "Tabor City",
            "state": "NC",
            "postal_code": "284638358",
            "country_code": "US",
            "telephone_number": "910-653-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Whiteville",
            "state": "NC",
            "postal_code": "284723704",
            "country_code": "US",
            "telephone_number": "910-641-8625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AJIBADE",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2017-01344",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "35229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

Verify at the official NPI Registry.