Individual provider Active NPI

Bolarinwa Akanbi, MD

  • Emergency Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1891749974
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
14507R Issued in LA
Practice address
4200 Nelson Rd
Lake Charles, LA 70605-4118
Phone
(281) 485-1903
NPI assigned
May 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 14507R LA Primary

Addresses

Primary practice location

4200 Nelson Rd
Lake Charles, LA 70605-4118

Mailing address

200 Corporate Blvd
Suite 201
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other identifiers 1

IdentifierTypeStateIssuer
1123781MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20050720000680 LA Practitioner - Emergency Medicine 5597792697 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14507RLAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Louisiana Inc Emergency Medicine CurrentSince Sep 1, 2019 Accepting new patients
Village Chiropractic and Wellness P.L.L.C. Past Accepting new patients
Sulphur Emergency Group LLC Emergency Medicine Past Accepting new patients
Southeast Emergency Physician Associates, P.a. Emergency Medicine Past Accepting new patients
G.T. Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

4200 Nelson Rd
Lake Charles, LA 70605
Phone (318) 474-6370

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1148169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1891749974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 NELSON RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054118",
            "telephone_number": "281-485-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKANBI",
        "first_name": "BOLARINWA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-21",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "14507R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1123781",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.