Individual provider Active NPI

Oluwadamilola Solabi Omoniyi, MD

  • Developmental - Behavioral Pediatrics Physician
  • Akron, OH
National Provider Identifier
1508642828
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
57.255755 Issued in OH
Practice address
215 W Bowery St
Akron, OH 44308-1069
Phone
(330) 543-8050
NPI assigned
Sep 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 57.255755 OH Primary

Addresses

Primary practice location

215 W Bowery St
Akron, OH 44308-1069

Mailing address

1 Canal Square PLZ Apt 1302
Akron, OH 44308-1061
Phone (945) 217-2711

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57.255755OHMDDevelopmental - Behavioral Pediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1508642828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CANAL SQUARE PLZ APT 1302",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081061",
            "telephone_number": "945-217-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W BOWERY ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081069",
            "telephone_number": "330-543-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMONIYI",
        "first_name": "OLUWADAMILOLA",
        "middle_name": "SOLABI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "OH",
            "license": "57.255755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.