Active NPI
Shuaib Abiodun Taiwo, PT
- Physical Therapist
- Indianapolis, IN
National Provider Identifier
1861813560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- A5011322A
- Practice address
- 4994 Oakbrook Dr
Apt a
Indianapolis, IN 46254-1166 - Phone
- (317) 704-4323
- Fax
- (347) 919-5546
- NPI assigned
- Dec 23, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | A5011322A | IN | Primary |
Addresses
Primary practice location
4994 Oakbrook Dr
Apt a
Indianapolis, IN 46254-1166
Mailing address
4994 Oakbrook Dr
Apt a
Indianapolis, IN 46254-1166
Phone (317) 704-4323
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
| License | State | Type | Specialty |
|---|---|---|---|
| A5011322A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387756800000",
"number": "1861813560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4994 OAKBROOK DR",
"address_2": "APT A",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462541166",
"telephone_number": "317-704-4323",
"fax_number": "347-919-5546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4994 OAKBROOK DR",
"address_2": "APT A",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462541166",
"telephone_number": "317-704-4323",
"fax_number": "347-919-5546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAIWO",
"first_name": "SHUAIB",
"middle_name": "ABIODUN",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-23",
"last_updated": "2013-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "A5011322A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.