Yetunde A. Adesanya, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2008-00941 Issued in NC

Practice address

3115 Bordeaux Park Dr
Fayetteville, NC 28306-2894

Phone

(910) 307-7337

Fax

(910) 323-4620

NPI assigned

Jun 17, 2008

Last updated

Nov 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 15

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Kidzcare Pediatrics, PC

  • Pediatrics Physician
  • Fayetteville, NC
  • NPI 1164657532
  NPD (past)
• Kidzcare Pediatrics, PC

  • Pediatrics Physician
  • Spring Lake, NC
  • NPI 1629394614
  NPD (past)
• Kidzcare Pediatrics, PC

  • Pediatrics Physician
  • Hope Mills, NC
  • NPI 1679529051
  NPD (past)

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1689834269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5617 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111423",
            "telephone_number": "910-483-7337",
            "fax_number": "910-483-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 BORDEAUX PARK DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062894",
            "telephone_number": "910-307-7337",
            "fax_number": "910-323-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADESANYA",
        "first_name": "YETUNDE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2008-00941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET FEDERAL SERVICES",
            "identifier": "1689834269",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST, LLC",
            "identifier": "217771",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3038401",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY NATIONAL - COVENTRY PPO",
            "identifier": "4015906",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY OF THE CAROLINAS",
            "identifier": "1045067",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689834269",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLPATH",
            "identifier": "1045067",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS-MULTIPLAN",
            "identifier": "12735847",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSMART",
            "identifier": "1689834269",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "1603J",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1689834269",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GREATWEST",
            "identifier": "4101857",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9297402",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOCTORS DIRECT",
            "identifier": "1689834269",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CAROLINA CARE",
            "identifier": "FH1101555",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nimet Adatia, DDS
• Kehinde Adediran
• Faith Adedoyin
• Eugene Adei, DMD
• Abimbola Victoria Aderibigbe, PHARM.D
• Adg and Associates, LLC
• Paul Odak Adholla, MD
• Adjust Experience Chiropractic, P. a.
• Mary Jennifer Adkins, LMBT
• Taylor Diana Adkins, PT, DPT

• Pediatrics Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.