Olumayomide Coker, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.033190 Issued in IL

Practice address

402 S Lewis LN
Carbondale, IL 62901-3547

Phone

(618) 519-9200

Fax

(618) 519-9375

NPI assigned

Jun 25, 2021

Last updated

Jun 25, 2021By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Southern Illinois Univ School of Dental Medicine, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: olumayomide.coker.p11@direct.fhn-fqhc.nextgenshare.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.

• Promise Healthcare NFP

  dba Frances Nelson Health Center

  • Federally Qualified Health Center (FQHC)
  • Champaign, IL
  • NPI 1578821005
  Medicare reassignment
• Promise Healthcare NFP

  dba Promise Healthcare - Kenyon

  • Federally Qualified Health Center (FQHC)
  • Champaign, IL
  • NPI 1588453724
  NPD
• Promise Healthcare NFP

  dba Promise Healthcare - Ready School

  • Federally Qualified Health Center (FQHC)
  • Champaign, IL
  • NPI 1801687728
  NPD

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1851961577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CALIFORNIA ST, PO BOX 577",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629180577",
            "telephone_number": "618-519-9200",
            "fax_number": "618-985-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S LEWIS LN",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013547",
            "telephone_number": "618-519-9200",
            "fax_number": "618-519-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COKER",
        "first_name": "OLUMAYOMIDE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.033190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruthann Coale, APRN
• Melissa Ann Cobin, CCC-SLP
• Cesar E Coello, M.D.
• Tammy A Coffer, DT
• Janet Moore Coffman, PH.D.
• Clifford Loren Coleman, M.D.
• Benjamin Ellison Collie, M.D.
• Jessika Collins, FNP-BC
• Community Health & Emergency Services, Inc (Cedar Court Specialty Clinic)
• Community Health & Emergency Services, Inc. (Cedar Court Clinic)

• General Practice Dentistry in Carbondale, IL
• Providers in Carbondale, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.