Modinat Abidemi Adewale

Key facts

NPI

1548088016

Entity type

Individual (NPI type 1)

Primary specialty

Transportation Broker 347E00000X

Practice address

4002 S Loop 256 Ste F
Palestine, TX 75801-8493

Phone

(718) 414-3142

NPI assigned

Oct 2, 2024

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 2, 2024.

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1548088016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 S LOOP 256 STE F",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758018493",
            "telephone_number": "718-414-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 S LOOP 256 STE F",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758018493",
            "telephone_number": "718-414-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEWALE",
        "first_name": "MODINAT",
        "middle_name": "ABIDEMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

• Adams NP Medical Services, PLLC
• Leia R Adams-Gray, LMSW
• Cason Lane Adams, CRNA
• Erin Adams, M.S. CCC-SLP
• Adebayo Adewale, M.D
• Advance Neurology Care PA
• Ahm Action Home Health, LP
• Alan D. Shiller M.D., P.a.
• Allen Family Dentistry - Palestine PLLC
• Steven L Allen, DMD

All providers in Palestine, TX · Transportation Broker in Texas