Ayobami Oduwole

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2019029806 Issued in MO

Practice address

13013 Fuller Ave Ste a
Grandview, MO 64030-2687

Phone

(816) 214-5548

NPI assigned

Jun 19, 2021

Last updated

Jun 19, 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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Medina Clinic, Incorporated

  dba The Medina Clinic

  • Primary Care Clinic/Center
  • Grandview, MO
  • NPI 1073893046
  NPD (past)

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

{
    "created_epoch": "1624060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624060800000",
    "number": "1871162396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13013 FULLER AVE STE A",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640302687",
            "telephone_number": "816-214-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13013 FULLER AVE STE A",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640302687",
            "telephone_number": "816-214-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUWOLE",
        "first_name": "AYOBAMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-19",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2019029806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nova Center Inc.
• Nova Centrer Inc.
• Occupational Health Centers of Kansas PA (Concentra Medical Center)
• Occupational Health Centers of Kansas PA (Concentra Medical Centers)
• Occupational Health Centers of Kansas PA (Concentra Medical Center)
• Jafar Ohiokpehai, MD
• Ashlee Olson
• Oness Home Health LLC
• Open and Affordable Dental Grandview LLC
• Open Doors Adult Day Care Services

• Family Medicine Physician in Grandview, MO
• Providers in Grandview, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.