Adetokunbo Olukorede Omoruyi, M.D

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

42024 Issued in KY

Practice address

601 S Floyd St
Ste 403
Louisville, KY 40202-1837

Phone

(502) 588-3400

Fax

(502) 588-3401

NPI assigned

Apr 18, 2007

Last updated

Sep 9, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Dr. Adetokunbo Olukorede Dawodu Former name

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Pearl Geriatrics and Palliative Medicine, PSC

  • Geriatric Medicine (Internal Medicine) Physician
  • Louisville, KY
  • NPI 1376865972
  Medicare reassignment NPD
• University of Louisville Physicians, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1366722316

  Pediatrics

  Medicare reassignment NPD
• University of Louisville Physicians, Inc.

  dba ULP Radiological Associates

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1316294127
  NPD
• University of Louisville Physicians, Inc.

  dba ULP Colorectal Surgery

  • Colon & Rectal Surgery Physician
  • Louisville, KY
  • NPI 1568732097
  NPD
• Pearl Medical Practice PLLC

  • Primary Care Clinic/Center
  • Louisville, KY
  • NPI 1669841631
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1427275049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-3400",
            "fax_number": "502-588-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S FLOYD ST",
            "address_2": "STE 403",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021837",
            "telephone_number": "502-588-3400",
            "fax_number": "502-588-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMORUYI",
        "first_name": "ADETOKUNBO",
        "middle_name": "OLUKOREDE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "42024",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "OH",
            "license": "35.086930",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "KY",
            "license": "42024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200919290",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100062650",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADETOKUNBO",
            "last_name": "DAWODU",
            "middle_name": "OLUKOREDE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Endashaw Mahmud Omer, MD
• Omni Community Public Health and Wellness Center
• Omni Family of Services Kentucky, Inc.
• Omni Resource Services
• Omni Resource Services Inc Public Health and Wellness Center
• Osawaru Jude Omoruyi, M.D
• Omspt Holdings LLC
• On Demand Kare
• On Time Health Transport
• On-Site Dermatology Consultants

• Pediatric Endocrinology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Endocrinology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.