NPIMap

Individual provider Active NPI

Olufolarin Akanfe Ajao, M.D.

  • Internal Medicine Physician
  • Gastonia, NC
National Provider Identifier
1528059920
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
95-01167 Issued in NC
Practice address
2664 Court Drive
Suite a
Gastonia, NC 28054-1449
Phone
(704) 861-9030
Fax
(704) 833-1234
NPI assigned
Nov 3, 2005
Last updated
Feb 17, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 95-01167 NC Primary

Addresses

Primary practice location

2664 Court Drive
Suite a
Gastonia, NC 28054-1449

Mailing address

2664 Court Drive
Suite a
Gastonia, NC 28054-1449
Phone (704) 861-9030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100510000526 NC Practitioner - Internal Medicine 2062563760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Columbia University College of Physicians and Surgeons, 1993
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Gaston Medical Associates PAGroup PAC ID 0244381945, 4 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

2664 Court Dr
Gastonia, NC 28054-1449
Phone 70486190301012

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
95-01167NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Medical Associates, PA Internal Medicine CurrentSince Apr 18, 2000 Accepting new patients

Locations

2664 Court Dr
Gastonia, NC 28054
Phone (704) 861-9030

2664 Court Dr
#A
Gastonia, NC 28054
Phone (704) 861-9030

2664 Court Dr
Ste A
Gastonia, NC 28054
Phone (704) 861-9030

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAIEDD

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1528059920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2664 COURT DRIVE",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541449",
            "telephone_number": "704-861-9030",
            "fax_number": "704-833-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2664 COURT DRIVE",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541449",
            "telephone_number": "704-861-9030",
            "fax_number": "704-833-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAO",
        "first_name": "OLUFOLARIN",
        "middle_name": "AKANFE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "95-01167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.