Ini-Abasi Joyce Olutade, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

16022 Issued in MS

Practice address

100 Business Park Dr Ste a
Ridgeland, MS 39157-6015

Phone

(601) 991-3040

Fax

(601) 991-3399

NPI assigned

Sep 26, 2006

Last updated

Mar 9, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ini-abasi.olutade.1@20428.direct.athenahealth.com

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.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• River Oaks Management Company LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1922029040
  NPD (past)
• University Family Medicine Associates, PLLC

  • Clinic/Center
  • Jackson, MS
  • NPI 1396846648
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1902907223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BUSINESS PARK DR STE A",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391576015",
            "telephone_number": "601-991-3040",
            "fax_number": "601-991-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BUSINESS PARK DR STE A",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391576015",
            "telephone_number": "601-991-3040",
            "fax_number": "601-991-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUTADE",
        "first_name": "INI-ABASI",
        "middle_name": "JOYCE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "16022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0119586",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Odom
• Judy Sullivan Oglesby, CCC-SLP
• Amy B Oliver, OT
• Jasmyn Joanne Olson
• Tracy Scott Olson, OTR/L
• Omniverse Plastikos PA
• On Demand Diagnostics LLC
• Elizabeth Orr, FNP
• Abigail Ann Ott
• Haley Overby

• Family Medicine Physician in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.