Omoniyi Yakubu Adebisi, MD, DABFP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

38880 Issued in TN

Practice address

3030 Covington Pike
Suite 100
Memphis, TN 38128-5048

Phone

(901) 383-8889

Fax

(901) 383-2245

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Camellia Foundation

  • Family Medicine Physician
  • Memphis, TN
  • NPI 1609169713

  Family Medicine

  NPD
• Tennessee Em-I Medical Services, PC

  • Emergency Medicine Physician
  • Memphis, TN
  • NPI 1497703714
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285891200000",
    "number": "1689622128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "TALLAPOOSA",
            "state": "GA",
            "postal_code": "301760215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 COVINGTON PIKE",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285048",
            "telephone_number": "901-383-8889",
            "fax_number": "901-383-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEBISI",
        "first_name": "OMONIYI",
        "middle_name": "YAKUBU",
        "name_prefix": "Dr.",
        "credential": "MD, DABFP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2010-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "38880",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "TN",
            "license": "38880",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3896669",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Addiction & Mental Health Services, LLC
• Amanda Addington, M.D.
• Milton Alexander Addington, MD
• Olugbenga Alaba Adebanjo, M.D
• Titilola Tolulope Adebanjo, N.P.
• Adedayo Ademola Adeboye, MD
• Oluwatobi Adedayo Adedokun, MD
• Stephen Deji Adedokun
• Adedayo Adegbile, MD
• Ayodele O Adelanwa, MD

• All providers in Memphis, TN
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; 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.