Individual provider Active NPI

Betty Orieji Agbede, MD MPH

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1881708691
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME111451 Issued in FL
Practice address
5554 Clarcona Ocoee Rd
Orlando, FL 32810
Phone
(407) 292-0292
Fax
(407) 292-5175
NPI assigned
Aug 18, 2006
Last updated
Mar 22, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD040841E PA
Family Medicine Physician 207Q00000X 2010-00664 NC
Family Medicine Physician 207Q00000X ME111451 FL Primary

Addresses

Primary practice location

5554 Clarcona Ocoee Rd
Orlando, FL 32810

Mailing address

PO Box 616788
Orlando, FL 32861-6788
Phone (407) 244-7701

Other identifiers 1

IdentifierTypeStateIssuer
011697570004MedicaidPA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2010-00664NCMDFamily Medicine Physician
MD040841EPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care (FL) Inc. Family Medicine CurrentSince Apr 1, 2013 Accepting new patients
Buckhead Express Clinic PC Family Medicine Past Accepting new patients
Fayetteville Medical Clinic, PC Past Accepting new patients

Locations

4300 Clarcona Ocoee Rd
Ste 407
Orlando, FL 32810
Phone (321) 292-0292

5554 Clarcona Ocoee Rd
Orlando, FL 32810
Phone (407) 292-0292

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1881708691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 616788",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328616788",
            "telephone_number": "407-244-7701",
            "fax_number": "407-770-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5554 CLARCONA OCOEE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32810",
            "telephone_number": "407-292-0292",
            "fax_number": "407-292-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBEDE",
        "first_name": "BETTY",
        "middle_name": "ORIEJI",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD040841E",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2010-00664",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME111451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011697570004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.

Verify at the official NPI Registry.