Kikelomo Ogundiran

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

10 Mont Ave
Dix Hills, NY 11746-6836

Phone

(631) 807-2763

Fax

(631) 807-2763

NPI assigned

Sep 26, 2007

Last updated

Sep 26, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kikelomo Balogun Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1598952392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MONT AVE",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466836",
            "telephone_number": "631-807-2763",
            "fax_number": "631-807-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MONT AVE",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466836",
            "telephone_number": "631-807-2763",
            "fax_number": "631-807-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNDIRAN",
        "first_name": "KIKELOMO",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIKELOMO",
            "last_name": "BALOGUN",
            "credential": "MSED",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Case Manager/Care Coordinator in Dix Hills, NY
• Providers in Dix Hills, NY by specialty
• Case Manager/Care Coordinator in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.