NPIMap

Individual provider Active NPI

Adebola K. Adekanmbi, MD

  • Internal Medicine Physician
  • Concord, NC
National Provider Identifier
1609921212
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9900744 Issued in NC
Practice address
271 Executive Park Dr
Concord, NC 28025-1895
Phone
(704) 721-4232
Fax
(704) 721-4232
NPI assigned
Jan 24, 2007
Last updated
May 19, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 9900744 NC
Internal Medicine Physician 207R00000X 9900744 NC Primary

Addresses

Primary practice location

271 Executive Park Dr
Concord, NC 28025-1895

Mailing address

271 NE Executive Park Drive
Providence Medical Clinic, in Dba Cabarrus Mercy Clinic
Concord, NC 28025
Phone (704) 707-4601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040205000403 NC Practitioner - Internal Medicine 8123911914 Reassigns benefits to 2 organizations
I20120917000399 SC Practitioner - Emergency MedicinePractitioner - Internal Medicine 8123911914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Carolinas Emergency Group, PLLCGroup PAC ID 2567486814, 62 clinicians
Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians

Practice addresses (Care Compare)

2301 US Hwy 74 W
Wadesboro, NC 28170-7554
Phone (704) 694-5131

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
98.67
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9900744NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Emergency Providers CurrentSince Sep 1, 2025 Accepting new patients
The Carolinas Emergency Group, PLLC Emergency Medicine CurrentSince Jun 1, 2012 Accepting new patients
Sound Physicians Emergency Medicine of South Carolina LLC Emergency Medicine CurrentSince Oct 1, 2016 Accepting new patients
Ies South Carolina LLC Emergency Medicine CurrentSince Feb 1, 2026 Accepting new patients
National Emergency Services North Carolina Inc Emergency Medicine Past Accepting new patients
Neuse River Emergency Physicians Emergency Medicine Past Accepting new patients
Vance Emergency Physicians Emergency Medicine Past Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

2301 US Highway 74 W
Wadesboro, NC 28170
Phone (704) 694-5131

500 Morven Rd
Wadesboro, NC 28170
Phone (704) 694-5131

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

1304 W Bobo Newsom Hwy
Hartsville, SC 29550
Phone (469) 340-1366

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 9

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.

Hospital & facility affiliations 7

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1609921212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 NE EXECUTIVE PARK DRIVE",
            "address_2": "PROVIDENCE MEDICAL CLINIC, IN DBA CABARRUS MERCY CLINIC",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28025",
            "telephone_number": "704-707-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 EXECUTIVE PARK DR",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251895",
            "telephone_number": "704-721-4232",
            "fax_number": "704-721-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEKANMBI",
        "first_name": "ADEBOLA",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "9900744",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9900744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.