Individual provider Active NPI

Oluwaseun T Awobusuyi, D.C.

  • Chiropractor
  • Melbourne, FL
National Provider Identifier
1477831790
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 10378 Issued in FL
Practice address
1575 Sarno Rd
Melbourne, FL 32935-5209
Phone
(321) 409-0021
Fax
(321) 676-8425
NPI assigned
Aug 3, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 10378 FL Primary

Addresses

Primary practice location

1575 Sarno Rd
Melbourne, FL 32935-5209

Mailing address

1575 Sarno Rd
Melbourne, FL 32935-5209
Phone (321) 409-0021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 10378FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands Chiropractic Wellness Center LLC CurrentSince Oct 4, 2011 Accepting new patients

Locations

1575 Sarno Rd
Melbourne, FL 32935
Phone (321) 409-0021

2415 S Babcock St
Ste C
Melbourne, FL 32901
Phone (321) 409-0021

1454 Bellaire Ln NE
Palm Bay, FL 32905
Phone (321) 409-0021

Organizations & group practices 1

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": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1477831790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 SARNO RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355209",
            "telephone_number": "321-409-0021",
            "fax_number": "321-676-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 SARNO RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355209",
            "telephone_number": "321-409-0021",
            "fax_number": "321-676-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWOBUSUYI",
        "first_name": "OLUWASEUN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-03",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.