Active NPI
Yetunde Bosede Sowunmi, APRN
- Family Nurse Practitioner
- Indianapolis, IN
National Provider Identifier
1881452167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71015015A
- Practice address
- 602 N High School Rd Ste B
Indianapolis, IN 46214-3695 - Phone
- (317) 291-1211
- NPI assigned
- Mar 11, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71015015A | IN | Primary |
Addresses
Primary practice location
602 N High School Rd Ste B
Indianapolis, IN 46214-3695
Mailing address
10293 Kings Gap Way
Indianapolis, IN 46234-9832
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 |
|---|---|---|---|
| 71015015A | IN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710374400000",
"number": "1881452167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10293 KINGS GAP WAY",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462349832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 N HIGH SCHOOL RD STE B",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462143695",
"telephone_number": "317-291-1211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOWUNMI",
"first_name": "YETUNDE",
"middle_name": "BOSEDE",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-11",
"last_updated": "2024-03-14",
"certification_date": "2024-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71015015A",
"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 Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.