Individual provider Active NPI

Olushola O Oluyeba

  • Home Health Agency
  • Plainfield, IL
National Provider Identifier
1619791985
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
12617 Blue Iris LN
Plainfield, IL 60585-2857
Phone
(630) 803-0093
NPI assigned
Nov 13, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

12617 Blue Iris LN
Plainfield, IL 60585-2857

Mailing address

12617 Blue Iris LN
Plainfield, IL 60585-2857
Phone (630) 803-0093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
J4 & Beaux LLC Home Health CurrentSince Nov 17, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1619791985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12617 BLUE IRIS LN",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605852857",
            "telephone_number": "630-803-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12617 BLUE IRIS LN",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605852857",
            "telephone_number": "630-803-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUYEBA",
        "first_name": "OLUSHOLA",
        "middle_name": "O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.