Oluwagbenga Koriko, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-146454 Issued in AL

Practice address

1758 Park PL Ste 300
Montgomery, AL 36106-1137

Phone

(334) 293-8922

NPI assigned

Sep 23, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Hospital and Clinic, IncGroup PAC ID 0547254153, 119 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: oluwagbenga.koriko.1@9186.direct.athenahealth.com

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.

• Jackson Hospital and Clinic, Inc.

  • Emergency Medicine Physician
  • Montgomery, AL
  • NPI 1073264107
  Medicare reassignment Care Compare group
• Jackson Hospital & Clinic, Inc.

  • General Acute Care Hospital
  • Montgomery, AL
  • NPI 1043262488
  NPD (past)

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1427875475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1758 PARK PL STE 300",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061137",
            "telephone_number": "334-293-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1758 PARK PL STE 300",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061137",
            "telephone_number": "334-293-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORIKO",
        "first_name": "OLUWAGBENGA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-146454",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-146454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Kohn Jr., P.T.
• Katherine Kolacki, PSYD
• John Kolawole, MD
• Sarah Krause Kondrak, CRNP
• Jauhn Koo, DDS
• Roxanne Koteles
• David Lawrence Kouri, M.D.
• Jeremy Alan Kovacs, DPT, OCS
• Mary Alesha Kozlowski
• Molly Katrina Kracht, PHARMD

• Family Nurse Practitioner in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.