Organization Active NPI

Apple Valley Family Medicine and Urgent Care

  • Family Medicine Physician
  • Martinsburg, WV
National Provider Identifier
1558735209
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25370 Issued in WV
Legal business name
APPLE VALLEY FAMILY MEDICINE AND URGENT CARE
Practice address
202 Foxcroft Ave
Martinsburg, WV 25401-5312
Phone
(240) 476-0791
NPI assigned
Nov 18, 2015
Last updated
Jan 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Dr. Kolawale Adedeji Oshiyoye, MDNPI 1427362383
Title
Ceo
Phone
(240) 476-0791

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU
Family Medicine Physician 207Q00000X 25370 WV Primary

Addresses

Primary practice location

202 Foxcroft Ave
Martinsburg, WV 25401-5312

Mailing address

202 Foxcroft Avenue
Martinsburg, WV 25401
Phone (240) 476-0791

Other identifiers 1

IdentifierTypeStateIssuer
1427362383OtherWVNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160825002587 WV Part B Supplier - Clinic/Group Practice 2769777085 Receives reassigned benefits from 5 practitioners
Practice locations: Martinsburg, WV; Shepherdstown, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2109283Apple Valley Family Medicine202 Foxcroft Avenue, Martinsburg, WV 25401Certificate of waiverFeb 22, 2028

National Provider Directory

National Provider Directory

Locations

7595 Martinsburg Pike
Shepherdstown, WV 25443
Phone (304) 907-2191

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1558735209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 FOXCROFT AVENUE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25401",
            "telephone_number": "240-476-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 FOXCROFT AVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254015312",
            "telephone_number": "240-476-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLE VALLEY FAMILY MEDICINE AND URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "OSHIYOYE",
        "authorized_official_first_name": "KOLAWALE",
        "authorized_official_middle_name": "ADEDEJI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-476-0791",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "25370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1427362383",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.