Igbagboleke Mobolaji

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101290381 Issued in VA

Practice address

1900 Electric Rd
Salem, VA 24153-7474

Phone

(540) 776-4793

NPI assigned

Mar 24, 2025

Last updated

Aug 31, 2026By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: igbagboleke.mobolaji@hca6.eclinicaldirectplus.com

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1609677780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 CATAWBA HOSPITAL DR",
            "city": "CATAWBA",
            "state": "VA",
            "postal_code": "240702115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ELECTRIC RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537474",
            "telephone_number": "540-776-4793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5525 Catawba Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Catawba",
            "state": "VA",
            "postal_code": "240702115",
            "country_code": "US",
            "telephone_number": "540-375-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOBOLAJI",
        "first_name": "IGBAGBOLEKE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-03-24",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101290381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Ann Mittermeyer-Parkman
• Kimberly A Mizack, P.A.
• Winnie Tyndall Mizuba, PHARMD
• Mobility Plus, Inc. of Virginia
• Julie Anne Mobley, MD
• James Kelly Moles Jr., MD
• Jenilee Montes de Oca
• Sandra Kay Boone Montgomery, LCSW
• Annette Nelalen Moore, OTR/L
• Jimmy Moore, MSW,LCSW

• Internal Medicine Physician in Salem, VA
• Providers in Salem, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; 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.