Abimbola A Odukoya, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01062400A Issued in IN

Practice address

3741 Rome Dr
Suite B
Lafayette, IN 47905-4490

Phone

(765) 607-6160

Fax

(765) 607-6161

NPI assigned

Sep 22, 2006

Last updated

Oct 15, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: abimbola.odukoya.1@7794.direct.athenahealth.com

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.

• Joint Heirs Pediatrics LLC

  dba Healthy Horizons Pediatrics

  • Pediatrics Physician
  • Kokomo, IN
  • NPI 1164859880
  NPD (past) Authorized official

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1770683732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3741 ROME DR",
            "address_2": "SUITE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054490",
            "telephone_number": "765-607-6160",
            "fax_number": "765-607-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 ROME DR",
            "address_2": "SUITE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054490",
            "telephone_number": "765-607-6160",
            "fax_number": "765-607-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUKOYA",
        "first_name": "ABIMBOLA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "61002723",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01062400A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN STATE LICENSE",
            "identifier": "01062400A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "61002723",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200908770",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick R O'Neil, M.D.
• Sarah O'Neill
• Ashley O'Shields, FNP
• Courtney N Oakley, OD
• Shannon K Oates, MD
• Ayodeji Oduola, M.D.
• Abigail Ogden, RBT
• Omowunmi Ayodele Ogunsanya, PMHNP
• Jong Hak Oh
• Janelle Ohlemiller, LCSW

• Pediatrics Physician in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.