Individual provider Active NPI

Mariam Oluwatoyin Ayoola, LPN

  • Licensed Practical Nurse
  • Columbus, OH
National Provider Identifier
1861701682
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN140019 Issued in OH
Practice address
4422 Berthstone Dr
Columbus, OH 43231-8721
Phone
(614) 804-5283
NPI assigned
Sep 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN140019 OH Primary

Addresses

Primary practice location

4422 Berthstone Dr
Columbus, OH 43231-8721

Mailing address

4422 Berthstone Dr
Columbus, OH 43231-8721
Phone (614) 804-5283

Other identifiers 1

IdentifierTypeStateIssuer
2572381MedicaidOH

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
PN140019OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1861701682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 BERTHSTONE DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432318721",
            "telephone_number": "614-804-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 BERTHSTONE DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432318721",
            "telephone_number": "614-804-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYOOLA",
        "first_name": "MARIAM",
        "middle_name": "OLUWATOYIN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN140019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2572381",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; 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.