Individual provider Active NPI

Oluwadamilare Ajayi

  • Psychiatry Physician
  • Huntington, WV
National Provider Identifier
1740770106
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
30517 Issued in WV
Practice address
1115 20TH St Ste 205
Huntington, WV 25703-2071
Phone
(304) 691-1100
NPI assigned
May 11, 2018
Last updated
Jun 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X WV
Psychiatry Physician 2084P0800X 30517 WV Primary

Addresses

Primary practice location

1115 20TH St Ste 205
Huntington, WV 25703-2071

Mailing address

1115 20TH St Ste 205
Huntington, WV 25703-2071
Phone (304) 691-1100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address luwadamilare.ajayi@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220826001165 WV Practitioner - Psychiatry 0840674784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1115 20TH St
Suite 205
Huntington, WV 25703-2071
Phone (304) 691-1500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30517WVMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc. CurrentSince Jul 1, 2022 Accepting new patients
University Physicians & Surgeons, Inc CurrentSince Jul 1, 2022 Accepting new patients
Mildred Mitchell Bateman Hospital Past Accepting new patients

Locations

1115 20th St
Ste 205
Huntington, WV 25703
Phone (304) 691-1100

1448 10th Ave
Ste 304
Huntington, WV 25701
Phone (304) 691-6381

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

1 John Marshall Dr
Point Pleasant, WV 25550
Phone (304) 733-8735

Organizations & group practices 3

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 1

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": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1740770106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 20TH ST STE 205",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257032071",
            "telephone_number": "304-691-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 20TH ST STE 205",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257032071",
            "telephone_number": "304-691-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAYI",
        "first_name": "OLUWADAMILARE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-11",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WV",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "30517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "luwadamilare.ajayi@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1115 20th St Ste 205",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257032071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.