Individual provider Active NPI

Adesiji Joseph Adewunmi, APRN

  • Nurse Practitioner
  • Olathe, KS
National Provider Identifier
1811322308
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-76145 Issued in KS
Practice address
20805 W 151St St
Suite 400
Olathe, KS 66061-7249
Phone
(913) 780-4900
Fax
(913) 780-0949
NPI assigned
Sep 4, 2013
Last updated
Sep 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-76145 KS Primary

Addresses

Primary practice location

20805 W 151St St
Suite 400
Olathe, KS 66061-7249

Mailing address

20805 W 151St St
Suite 400
Olathe, KS 66061-7249
Phone (913) 780-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180821002029 OR Practitioner - Nurse Practitioner 5193951812 Reassigns benefits to 1 organization
I20230214001421 WA Practitioner - Nurse Practitioner 5193951812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Kansas School of Med (KC/Wich/Sal), 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

2400 Lancaster Dr NE
Salem, OR 97305-1221
Phone (800) 813-2000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 25, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 2, 2018 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1811322308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20805 W 151ST ST",
            "address_2": "SUITE 400",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617249",
            "telephone_number": "913-780-4900",
            "fax_number": "913-780-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20805 W 151ST ST",
            "address_2": "SUITE 400",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617249",
            "telephone_number": "913-780-4900",
            "fax_number": "913-780-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEWUNMI",
        "first_name": "ADESIJI",
        "middle_name": "JOSEPH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-04",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-76145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.