Eniola Antonia Ogundipe

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1107 W Don St
Wilmington, CA 90744-1211

Phone

(311) 040-8527

NPI assigned

Mar 29, 2022

Sex

Male

Sole proprietor

No

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

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1740920818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 W DON ST",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907441211",
            "telephone_number": "311-040-8527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 W DON ST",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907441211",
            "telephone_number": "311-040-8527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNDIPE",
        "first_name": "ENIOLA",
        "middle_name": "ANTONIA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eniola.ogundipe@cuanschutz.edu",
            "affiliation": "Y",
            "endpointDescription": "university email",
            "affiliationName": "University of Colorado School of Medicine",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1784 Racine St",
            "address_2": "Room R09-130",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800457144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Wilmington, CA
• Providers in Wilmington, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.