Individual provider Active NPI

Toyin F Bolaji

  • Gerontology Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1699752808
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1-137792 Issued in AL
Practice address
172 Luds Way
Dothan, AL 36303-6341
Phone
(334) 778-7090
Fax
(334) 788-7085
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1-137792 AL Primary

Addresses

Primary practice location

172 Luds Way
Dothan, AL 36303-6341

Mailing address

172 Luds Way
Dothan, AL 36303-6341
Phone (334) 778-7090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20171026000442 AL Practitioner - Nurse Practitioner 7911273586 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

172 Luds Way
Dothan, AL 36303-6341
Phone (334) 778-7090

Hospital & facility affiliations

  • Dale Medical Center Hospital, Ozark, AL, CCN 010021
  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001
  • Flowers Hospital Hospital, Dothan, AL, CCN 010055

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sha Diabetes Center LLC CurrentSince Jan 22, 2024 Accepting new patients
Dothan Medical Associates, P.C. CurrentSince Aug 20, 2017 Accepting new patients

Locations

1118 Ross Clark Cir
Ste 100
Dothan, AL 36301
Phone (334) 794-1148

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.37
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1699752808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 LUDS WAY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363036341",
            "telephone_number": "334-778-7090",
            "fax_number": "334-788-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 LUDS WAY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363036341",
            "telephone_number": "334-778-7090",
            "fax_number": "334-788-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAJI",
        "first_name": "TOYIN",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "1-137792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.