Individual provider Active NPI

Ayomidamope Ruth Adebiyi, NP

  • Family Nurse Practitioner
  • Merced, CA
National Provider Identifier
1558039255
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95018229 Issued in CA
Practice address
5200 N Lake Rd
Merced, CA 95343-5001
Phone
(209) 228-0010
NPI assigned
Aug 30, 2021
Last updated
Aug 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95018229 CA Primary
Occupational Health Nurse Practitioner 363LX0106X 95018229 CA

Addresses

Primary practice location

5200 N Lake Rd
Merced, CA 95343-5001

Mailing address

5200 N Lake Rd
Merced, CA 95343-5001

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95018229CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile-Med Work Health Solutions, Inc. CurrentSince Jul 23, 2023 Accepting new patients

Locations

5200 N Lake Rd
Merced, CA 95343
Phone (209) 228-2468

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1558039255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 N LAKE RD",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953435001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 N LAKE RD",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953435001",
            "telephone_number": "209-228-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEBIYI",
        "first_name": "AYOMIDAMOPE",
        "middle_name": "RUTH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018229",
            "primary": true
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "CA",
            "license": "95018229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.