Individual provider Active NPI

Adeshola A Afolabi, FNP

  • Family Nurse Practitioner
  • Fishers, IN
National Provider Identifier
1689982803
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004455A Issued in IN
Practice address
13861 Olio Rd
Fishers, IN 46037-3487
Phone
(317) 415-9000
NPI assigned
Sep 22, 2010
Last updated
Sep 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71004455A IN Primary
Registered Nurse 163W00000X 28204676A IN
Registered Nurse 163W00000X 578768-1 NY

Addresses

Primary practice location

13861 Olio Rd
Fishers, IN 46037-3487

Mailing address

250 W 96TH St # 520
Indianapolis, IN 46260-1316

Other identifiers 2

IdentifierTypeStateIssuer
201176490MedicaidIN
P01347689OtherINMEDICARE RR PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130904000673 IN Practitioner - Nurse Practitioner 5193968584 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

13500 N Meridian St
Carmel, IN 46032-1456
Phone (317) 582-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28204676AINMDRegistered Nurse
578768-1NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Solmed Care Concept Inc. Current Accepting new patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Aug 24, 2018 Accepting new patients
Aims, LLC CurrentSince Aug 31, 2017 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Aug 24, 2018 Accepting new patients
Aims-Med, LLC CurrentSince Oct 1, 2020 Accepting new patients
Saint Vincent Physician Services, Inc. Past Accepting new patients
Westmed, LLC PastSince May 17, 2020 Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

417 S Whitlock St
Bremen, IN 46506
Phone (574) 546-0330

13500 N Meridian St
Carmel, IN 46032
Phone (317) 573-7000

9330 Broadway
Crown Point, IN 46307
Phone (219) 648-2400

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

6720 Parkdale Pl
Indianapolis, IN 46254
Phone (219) 648-2400

8240 Naab Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 338-7450

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

111 E 3rd St
Unit 764
Mishawaka, IN 46546

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

Organizations & group practices 9

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 4

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": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1689982803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 96TH ST # 520",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13861 OLIO RD",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460373487",
            "telephone_number": "317-415-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFOLABI",
        "first_name": "ADESHOLA",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-22",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004455A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28204676A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "578768-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201176490",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PTAN",
            "identifier": "P01347689",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.