Matthew Idowu Ogunsile

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

QIDP Issued in SC

Practice address

216 Ashmore Bridge Rd
Mauldin, SC 29662-2841

Phone

(864) 907-2537

Fax

(864) 281-1332

NPI assigned

Oct 6, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1447912555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 ASHMORE BRIDGE RD",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622841",
            "telephone_number": "186-490-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 ASHMORE BRIDGE RD",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622841",
            "telephone_number": "864-907-2537",
            "fax_number": "864-281-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNSILE",
        "first_name": "MATTHEW",
        "middle_name": "IDOWU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "SC",
            "license": "QIDP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ogunsile1952@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Business E mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "216 Ashmore Bridge Rd",
            "city": "Mauldin",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296622841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Case Manager/Care Coordinator in Mauldin, SC
• Providers in Mauldin, SC by specialty
• Case Manager/Care Coordinator in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.