Omotayo Temitope Fawibe, MD

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

01076903A Issued in IN

Practice address

3978 New Vision Dr
Fort Wayne, IN 46845

Phone

(260) 672-4680

Fax

(260) 458-5836

NPI assigned

Apr 1, 2013

Last updated

Jul 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• American Current Care PA

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1013194455

  IN

  Medicare reassignment NPD
• Next Level MV LLC

  • Urgent Care Clinic/Center
  • Pearland, TX
  • NPI 1013432285
  Medicare reassignment NPD
• Nluc PLLC

  • Urgent Care Clinic/Center
  • Houston, TX
  • NPI 1518209113
  Medicare reassignment NPD
• Omotayo Fawibe MD LLC

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Fort Wayne, IN
  • NPI 1295494029
  NPD Authorized official
• American Current Care P.a.

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Beaumont, TX
  • NPI 1376356568
  NPD
• Next Level MV LLC

  dba Next Level Urgent Care

  • Urgent Care Clinic/Center
  • Baytown, TX
  • NPI 1073168746
  NPD
• Nluc PLLC

  dba Next Level Urgent Care-League City

  • Urgent Care Clinic/Center
  • League City, TX
  • NPI 1043814049
  NPD

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1851634554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3978 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "260-672-4680",
            "fax_number": "260-458-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWIBE",
        "first_name": "OMOTAYO",
        "middle_name": "TEMITOPE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-01",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "TX",
            "license": "S5894",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "IN",
            "license": "01076903A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Marie Faulkner, PTA
• Lynn Van Valer Faur, MD
• Jeremy Faux, RN
• Kelly N Fawcett, NP
• Eniola Oluwatosin Fawibe, NP-C
• Jacob M Fawley
• Fawver Waldo Clinic LLP
• David Arnold Feaker Jr., DO
• Leah M Fear, LMHCA
• Melissa K Fearnow, RDN, LD

• Occupational Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Occupational Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.