NPIMap

Individual provider Active NPI

Babatunde A Olumide, MD

  • Internal Medicine Physician
  • Saint Charles, MO
National Provider Identifier
1689771875
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2018002213 Issued in MO
Practice address
711 Veterans Memorial Pkwy Ste 300
Saint Charles, MO 63303-2106
Phone
(636) 669-2350
NPI assigned
Sep 20, 2006
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 10027 ND
Internal Medicine Physician 207R00000X 2018002213 MO Primary

Addresses

Primary practice location

711 Veterans Memorial Pkwy Ste 300
Saint Charles, MO 63303-2106

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Other practice location 1

800 3rd Ave SW
Rugby, ND 58368-1645
Phone (701) 776-5235

Other identifiers 1

IdentifierTypeStateIssuer
13561MedicaidND

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bolumide257584@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181218003206 MO Practitioner - Internal Medicine 6103859004 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 Genevieve Dr
Ste Genevieve, MO 63670-1434
Phone (573) 883-7772

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10027NDMDAdult Medicine Physician
2018002213MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Nov 11, 2018 Accepting new patients
Ste Genevieve County Memorial Hospital CurrentSince Jul 1, 2025 Accepting new patients
Ste. Genevieve County Memorial Hospital CurrentSince Sep 30, 2023 Accepting new patients
Analytical Pathology Services LTD Current Accepting new patients
Cogent Healthcare of Missouri, Inc CurrentSince Jan 1, 2022 Accepting new patients
Ste Genevieve County Memorial Hospital CurrentSince Sep 30, 2023 Accepting new patients
Northland Family Physicians LLC PastSince Sep 15, 2019 Accepting new patients
Alan F.H. Lim, M.D., P.C. Past Accepting new patients
Apogee Medical Group Tennessee PC Internal Medicine PastSince Oct 8, 2023 Accepting new patients
Aurora Urgent Care LLC PastSince Oct 1, 2006 Accepting new patients

Locations

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

800 Ste Genevieve Dr
Ste Genevieve, MO 63670
Phone (573) 883-2571

Interoperability endpoints

  • Direct secure messaging: bolumide257584@direct-ehr-ssmhc.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1689771875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 VETERANS MEMORIAL PKWY STE 300",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633032106",
            "telephone_number": "636-669-2350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 3rd Ave SW",
            "address_purpose": "LOCATION",
            "city": "Rugby",
            "state": "ND",
            "postal_code": "583681645",
            "country_code": "US",
            "telephone_number": "701-776-5235",
            "fax_number": "701-776-5297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLUMIDE",
        "first_name": "BABATUNDE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "ND",
            "license": "10027",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2018002213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13561",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bolumide257584@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bolumide257584@direct-ehr-ssmhc.com",
            "address_1": "711 Veterans Memorial Pkwy Ste 300",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633032106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "711 Veterans Memorial Pkwy Ste 300",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633032106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.