Bankole O Botu, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

33272 Issued in KY

Practice address

289 Ireland Ave
BLDG. 851 WTC Unit
Fort Knox, KY 40121-5111

Phone

(502) 624-9844

Fax

(502) 624-9578

NPI assigned

May 10, 2006

Last updated

Mar 24, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Carefirst Urgent Care Center LLC

  • Urgent Care Clinic/Center
  • Elizabethtown, KY
  • NPI 1699725234
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1548210834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 IRELAND AVE",
            "address_2": "BLDG. 851 WTC UNIT",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215111",
            "telephone_number": "502-624-9844",
            "fax_number": "502-624-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 IRELAND AVE",
            "address_2": "BLDG. 851 WTC UNIT",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215111",
            "telephone_number": "502-624-9844",
            "fax_number": "502-624-9578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTU",
        "first_name": "BANKOLE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "33272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64034242",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Beanblossom, LCSW
• Kayla Beekman
• Steven Wayne Binkley, DMD
• Richard Edward Borders, D.M.D.
• Laura Elizabeth Bottoms, RDN, LD
• Francis H Boudreau, MD
• Lucy Ann Bowen, PA-C
• Steven Casto Bowen, L.C.S.W.
• Steven Edward Braverman, M.D.
• Alexander Karl Brenner, PT

• Internal Medicine Physician in Fort Knox, KY
• Providers in Fort Knox, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.