Active NPI
Adetoun Faniyan
- Internal Medicine Physician
- Irving, TX
National Provider Identifier
1902244221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DR.0057219
- Practice address
- 3609 W Northgate Dr
Unit 217
Irving, TX 75062-8433 - Phone
- (347) 355-3994
- NPI assigned
- Jun 9, 2013
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | DR.0057219 | CO | Primary |
Addresses
Primary practice location
3609 W Northgate Dr
Unit 217
Irving, TX 75062-8433
Mailing address
3609 W Northgate Dr
Unit 217
Irving, TX 75062-8433
Phone (347) 355-3994
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
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0057219 | CO | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472169600000",
"number": "1902244221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3609 W NORTHGATE DR",
"address_2": "UNIT 217",
"city": "IRVING",
"state": "TX",
"postal_code": "750628433",
"telephone_number": "347-355-3994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3609 W NORTHGATE DR",
"address_2": "UNIT 217",
"city": "IRVING",
"state": "TX",
"postal_code": "750628433",
"telephone_number": "347-355-3994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANIYAN",
"first_name": "ADETOUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-09",
"last_updated": "2016-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "DR.0057219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.