NPIMap

Individual provider Active NPI

Gbemisola Mayokun Olayemi, M.D

  • Rheumatology Physician
  • Bridgeport, WV
National Provider Identifier
1689082109
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
28882 Issued in WV
Practice address
120 Medical Park Dr Ste 100
Bridgeport, WV 26330-9013
Phone
(681) 342-3490
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Rheumatology Physician 207RR0500X 28882 WV Primary

Addresses

Primary practice location

120 Medical Park Dr Ste 100
Bridgeport, WV 26330-9013

Mailing address

2673 Davisson Run Rd Ste 303
Clarksburg, WV 26301-7640
Phone (800) 541-4009

Other practice location 1

1978 Industrial Blvd
Houma, LA 70363-7055
Phone (985) 873-2710

Other practice location 2

18465 Orchard Trl
Lakeville, MN 55044-8885
Phone (952) 428-0950

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address golayemi141064@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address golayemi660087@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, MN2 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
I20190906000329 WV Practitioner - Rheumatology 3375839327 Reassigns benefits to 1 organization
I20240423001980 MN Practitioner - Rheumatology 3375839327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

18465 Orchard TRL
Lakeville, MN 55044-8885
Phone (952) 428-0950

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince May 28, 2024 Accepting new patients
United Hospital Center, Inc. Rheumatology CurrentSince Aug 26, 2019 Accepting new patients
Allina Health System Rheumatology CurrentSince May 28, 2024 Accepting new patients
United Hospital Center, Inc. CurrentSince Aug 26, 2019 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Past Accepting new patients
St Josephs Hospital of Buckhannon Rheumatology PastSince Jul 1, 2020 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

916 W Main St
Bridgeport, WV 26330
Phone (304) 842-1034

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

120 Medical Park Dr
Ste 100
Bridgeport, WV 26330
Phone (304) 842-3278

1 Amalia Dr
Buckhannon, WV 26201
Phone (304) 473-2000

2673 Davisson Run Rd
Ste 303
Clarksburg, WV 26301

Interoperability endpoints

  • Direct secure messaging: golayemi660087@excellian.direct.allina.com

Organizations & group practices 7

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.

Hospital & facility affiliations 38

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1689082109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2673 DAVISSON RUN RD STE 303",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263017640",
            "telephone_number": "800-541-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEDICAL PARK DR STE 100",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309013",
            "telephone_number": "681-342-3490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1978 Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Houma",
            "state": "LA",
            "postal_code": "703637055",
            "country_code": "US",
            "telephone_number": "985-873-2710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18465 Orchard Trl",
            "address_purpose": "LOCATION",
            "city": "Lakeville",
            "state": "MN",
            "postal_code": "550448885",
            "country_code": "US",
            "telephone_number": "952-428-0950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLAYEMI",
        "first_name": "GBEMISOLA",
        "middle_name": "MAYOKUN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WV",
            "license": "28882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "golayemi141064@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "120 Medical Park Dr",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263309012",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "golayemi660087@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "18465 Orchard Trl",
            "city": "Lakeville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550448885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.