Bamisegun Victor Olowofoyeku, M.D.

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

License

25939 Issued in NC

Practice address

508 Eastway Dr
Charlotte, NC 28205

Phone

(704) 248-0246

Fax

(704) 467-8351

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

General Surgery

Education

Howard University College of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Zenith Hope CenterGroup PAC ID 2567883184, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12291/brand/1/csg/1/fhir/r4

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.

• Zenith Hope Center

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1336693852
  Medicare reassignment Care Compare group NPD
• Hamlet Hma PPM LLC

  • General Practice Physician
  • Rockingham, NC
  • NPI 1164653499

  Internal Medicine

  NPD (past)
• Hamlet PPM LLC

  • Internal Medicine Physician
  • Hamlet, NC
  • NPI 1053558916
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585958400000",
    "number": "1669506861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8039 GROVE HALL AVE",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282273731",
            "telephone_number": "704-482-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 EASTWAY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28205",
            "telephone_number": "704-248-0246",
            "fax_number": "704-467-8351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "508 Eastway Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28205",
            "country_code": "US",
            "telephone_number": "704-248-0246",
            "fax_number": "704-467-8351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4200 Moorland Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282261112",
            "country_code": "US",
            "telephone_number": "704-541-3172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLOWOFOYEKU",
        "first_name": "BAMISEGUN",
        "middle_name": "VICTOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-04-04",
        "certification_date": "2020-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "25939",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "25939",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NC",
            "license": "25939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Ann Oliveras, NP
• Christina Michele Oliveri, BCBA
• Megan Marie Olivo
• Charisma Ollison
• Folake Olutosin Olojo, MD
• Linda Darnell Olowofoyeku, RN
• Cari L Olsen, AUDIOLOGIST
• Gary Michael Olsen, NP
• Kelly Shea Olsen, MD, PHD
• Paige Gocke Olsen, MD

• Addiction Medicine (Psychiatry & Neurology) Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.