Individual provider Active NPI

Mojirola Oguntoyinbo, NP

  • Nurse Practitioner
  • Hardeeville, SC
National Provider Identifier
1558570952
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5401576 Issued in SC
Practice address
552 Stiney Rd
Hardeeville, SC 29927-5228
Phone
(843) 784-2182
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5401576 SC Primary

Addresses

Primary practice location

552 Stiney Rd
Hardeeville, SC 29927-5228

Mailing address

PO Box 357
Ridgeland, SC 29936-2605
Phone (843) 987-7400

Other practice location 1

719 Okatie Hwy # 170
Okatie, SC 29909-3963
Phone (843) 987-7400

Other identifiers 1

IdentifierTypeStateIssuer
NP4216MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161212001940 SC Practitioner - Nurse Practitioner 4486567526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

721 Okatie Hwy
Okatie, SC 29909-3963
Phone (843) 987-7400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1576SCMDDental Hygienist
5401576SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort Jasper Hampton Comprehensive Health Services, Inc. CurrentSince Sep 26, 2016 Accepting new patients
Beaufort-Jasper-Hampton Comprehensive Health Service Inc Past Accepting new patients

Locations

721 Okatie Hwy
Okatie, SC 29909

719 Okatie Hwy
Okatie, SC 29909
Phone (843) 987-7408

719 N Okatie Hwy
Ridgeland, SC 29936
Phone (843) 322-1873

Interoperability endpoints

  • Direct secure messaging: mojirola.oguntoyinbo@bjhchs.eclinicaldirectplus.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1558570952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299362605",
            "telephone_number": "843-987-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 STINEY RD",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299275228",
            "telephone_number": "843-784-2182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "719 Okatie Hwy # 170",
            "address_purpose": "LOCATION",
            "city": "Okatie",
            "state": "SC",
            "postal_code": "299093963",
            "country_code": "US",
            "telephone_number": "843-987-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGUNTOYINBO",
        "first_name": "MOJIROLA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "5401576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4216",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hardeeville, SC

Sources for this page

Verify at the official NPI Registry.