Individual provider Active NPI

Adebola Adegbile, CNP

  • Family Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1699153106
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0028616 Issued in OH
Practice address
3812 Wales Dr
Dayton, OH 45405-1849
Phone
(614) 869-8630
NPI assigned
May 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0028616 OH
Family Nurse Practitioner 363LF0000X 0028616 OH Primary
Registered Nurse 163W00000X 413068 OH

Addresses

Primary practice location

3812 Wales Dr
Dayton, OH 45405-1849

Mailing address

3812 Wales Dr
Dayton, OH 45405-1849
Phone (614) 869-3830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20211104003117 OH Practitioner - Nurse Practitioner 1951790369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2351 Stanley Ave
Dayton, OH 45404-1201
Phone (937) 228-0990

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
413068OHMDRegistered Nurse
0028616OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Illumia Health LLC CurrentSince Aug 4, 2025 Accepting new patients
CG Medical Associates Inc CurrentSince Oct 1, 2021 Accepting new patients
Illumia Health LLC CurrentSince Aug 4, 2025 Accepting new patients
PA Post Acute Services PC CurrentSince Jan 21, 2024 Accepting new patients

Locations

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

4040 Embassy Pkwy
Ste 410
Akron, OH 44333
Phone (330) 576-5405

7300 Beechmont Ave
Cincinnati, OH 45230
Phone (513) 232-9100

4301 Clime Rd N
Columbus, OH 43228
Phone (614) 276-4400

1390 King Tree Dr
Dayton, OH 45405
Phone (718) 280-5436

1492 S Erie Hwy
Hamilton, OH 45011
Phone (513) 765-6890

8055 Addison Rd
Masury, OH 44438
Phone (330) 448-2547

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1431734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1699153106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 WALES DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454051849",
            "telephone_number": "614-869-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 WALES DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454051849",
            "telephone_number": "614-869-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEGBILE",
        "first_name": "ADEBOLA",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-16",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0028616",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0028616",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "413068",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.