Active NPI
Comfort Ajayi, CSA
- Surgical Assistant
- Grand Prairie, TX
National Provider Identifier
1528296795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 09196
- Practice address
- 3013 Harrell Dr Apt 202
Grand Prairie, TX 75052-7737 - Phone
- (817) 899-0540
- NPI assigned
- Jun 26, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 09196 | CO | Primary |
Addresses
Primary practice location
3013 Harrell Dr Apt 202
Grand Prairie, TX 75052-7737
Mailing address
3013 Harrell Dr
# 202
Grand Prairie, TX 75052
Phone (817) 899-0540
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09196 | CO | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245974400000",
"number": "1528296795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3013 HARRELL DR",
"address_2": "# 202",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "75052",
"telephone_number": "817-899-0540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3013 HARRELL DR APT 202",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750527737",
"telephone_number": "817-899-0540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AJAYI",
"first_name": "COMFORT",
"credential": "CSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-26",
"last_updated": "2009-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "CO",
"license": "09196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.