Individual provider Active NPI

Terell Adetunji

  • Licensed Practical Nurse
  • Lake Ozark, MO
National Provider Identifier
1669382909
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2026042125 Issued in MO
Practice address
130 Calo LN
Lake Ozark, MO 65049-9208
Phone
(573) 745-5253
NPI assigned
Sep 9, 2026
Last updated
Sep 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2026042125 MO Primary

Addresses

Primary practice location

130 Calo LN
Lake Ozark, MO 65049-9208

Mailing address

130 Calo LN
Lake Ozark, MO 65049-9208

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

NPI Registry JSON

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

{
    "created_epoch": "1788912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1669382909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CALO LN",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650499208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CALO LN",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650499208",
            "telephone_number": "573-745-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADETUNJI",
        "first_name": "TERELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-09",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2026042125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ozark, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.