Central Clinic, PC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

4301042822 Issued in MI

Legal business name

CENTRAL CLINIC, PC

Practice address

603 Lansing Ave
Jackson, MI 49202-3209

Phone

(517) 787-8371

Fax

(517) 787-2639

NPI assigned

Oct 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David O Oladele-Bankole, MDNPI 1083670087

Title

Owner

Phone

(517) 787-8371

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Olateju Oladele-Bankole, MD

  • Hematology & Oncology Physician
  • Bismarck, ND
  • NPI 1083670087

  MI

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285545600000",
    "number": "1649469743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 LANSING AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023209",
            "telephone_number": "517-787-8371",
            "fax_number": "517-787-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 LANSING AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023209",
            "telephone_number": "517-787-8371",
            "fax_number": "517-787-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2010-09-27",
        "status": "A",
        "authorized_official_last_name": "OLADELE-BANKOLE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-787-8371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301042822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2833980",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Center for Family Health
• Center for Family Health
• Center for Family Health
• Center for Family Health
• Center for Hematology-Oncology of S. Michigan
• Centre for Family Medicine P.C.
• Melissa Cerqueira, LMSW
• Colleen Chadderton, RNC, MSN, CPNP
• Crystal Ann Chaffee, LLMSW
• Andrew Carl Chalfant, D.C.

• Hematology & Oncology Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Hematology & Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.