David Babalola Ajagbe, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

R167930-4 Issued in MN

Practice address

2425 Eyrie Dr
Woodbury, MN 55129-4303

Phone

(651) 428-5704

NPI assigned

May 29, 2023

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1685318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685318400000",
    "number": "1902599871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 EYRIE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551294303",
            "telephone_number": "651-428-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 EYRIE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551294303",
            "telephone_number": "651-428-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAGBE",
        "first_name": "DAVID",
        "middle_name": "BABALOLA",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-29",
        "last_updated": "2023-05-29",
        "certification_date": "2023-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "R167930-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Registered Nurse in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Home Health Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2023; 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.