Individual provider Active NPI

Busola Oyebimpe Ogundipe

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Merrillville, IN
National Provider Identifier
1851668974
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
26021081A Issued in IN
Practice address
8001 Broadway Ste 202
Merrillville, IN 46410-5546
Phone
(219) 736-8105
NPI assigned
Nov 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 26021081A IN Primary

Addresses

Primary practice location

8001 Broadway Ste 202
Merrillville, IN 46410-5546

Mailing address

2610 William Dr
Valparaiso, IN 46385-8182
Phone (219) 707-5615

Other identifiers 1

IdentifierTypeStateIssuer
100307990MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26021081AINMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1851668974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 WILLIAM DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463858182",
            "telephone_number": "219-707-5615",
            "fax_number": "219-707-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 BROADWAY STE 202",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105546",
            "telephone_number": "219-736-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNDIPE",
        "first_name": "BUSOLA",
        "middle_name": "OYEBIMPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IN",
            "license": "26021081A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100307990",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.