Adeyemi Olubambo

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN210315 Issued in AZ

Practice address

661 W 10TH St
Mesa, AZ 85201-3204

Phone

(480) 938-8232

NPI assigned

Jan 4, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• The Vital Signs Health

  • Mental Illness Community Based Residential Treatment Facility
  • Mesa, AZ
  • NPI 1033904594
  NPD Authorized official

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1700599792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 W 10TH ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013204",
            "telephone_number": "480-938-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W 10TH ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013204",
            "telephone_number": "480-938-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUBAMBO",
        "first_name": "ADEYEMI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN210315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "yemi@thevitalsignshealth.com",
            "affiliation": "N",
            "address_1": "661 W 10th St",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852013204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamie J Olson
• Kelley K Olson, DPT
• Lindsay Nell Olson
• Malgorzata Olson
• Demarie M Olu-Williams, D.O
• Olusegun Olutedo
• Olve Pediatric Therapy PLLC
• Olympus Health Management LLC
• Shahd Omer
• Summer Omerza, RBT

• Registered Nurse in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.