Mofoluwake Omolade Awe, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2022-01354 Issued in NC

Practice address

91 Enterprise Dr
Rocky Mount, NC 27804-9590

Phone

(252) 451-3100

Fax

(252) 937-3106

NPI assigned

Apr 17, 2019

Sex

Female

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 NC

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 1

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 and National Provider Directory roles.

• Boice-Willis Clinic PA

  • Internal Medicine Physician
  • Rocky Mount, NC
  • NPI 1699722389

  Pediatrics

  Medicare reassignment NPD
• Boice-Willis Clinic, PA

  • Physical Therapy Clinic/Center
  • Rocky Mount, NC
  • NPI 1952557241
  NPD

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1871156570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 ENTERPRISE DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278049590",
            "telephone_number": "252-451-3100",
            "fax_number": "252-937-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 ENTERPRISE DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278049590",
            "telephone_number": "252-451-3100",
            "fax_number": "252-937-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWE",
        "first_name": "MOFOLUWAKE",
        "middle_name": "OMOLADE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2022-01354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiera Ausby
• Autumn Corporation
• John Thomas Avent, M.D.
• Avents Supervised Living
• Avutox, LLC
• B T L Charter LLC
• Harold A Bailey, MD
• Susan L Baker, FNP-BC
• Amanda Nash Baldwin, NNP-BC
• Donald W Bales, MD

• Pediatrics Physician in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.