Active NPI
Ogiemwonyi Elekhuoba Asemota, M.D
- Pediatrics Physician
- Fayetteville, NC
National Provider Identifier
1902912397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 9700454
- Practice address
- 509 Sandhurst Dr
Fayetteville, NC 28304-4433 - Phone
- (910) 484-4233
- Fax
- (910) 484-2990
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 9700454 | NC | Primary |
Addresses
Primary practice location
509 Sandhurst Dr
Fayetteville, NC 28304-4433
Mailing address
509 Sandhurst Dr
Fayetteville, NC 28304-4433
Phone (910) 484-4233
Other practice location 1
514 Owen Dr
Fayetteville, NC 28304-3432
Phone (910) 423-4233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891066J | Medicaid | NC |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9700454 | NC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunshine Pediatrics of NC PLLC | Pediatrics | Current | Accepting new patients |
| Calvary Pediatrics | Pediatrics | Past | Accepting new patients |
Locations
509 Sandhurst Dr
Fayetteville, NC 28304
Phone (910) 484-4233
514 Owen Dr
Fayetteville, NC 28304
Phone (910) 423-4233
Organizations & group practices 2
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": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1902912397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 SANDHURST DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283044433",
"telephone_number": "910-484-4233",
"fax_number": "910-484-2990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 SANDHURST DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283044433",
"telephone_number": "910-484-4233",
"fax_number": "910-484-2990"
}
],
"practiceLocations": [
{
"address_1": "514 Owen Dr",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "NC",
"postal_code": "283043432",
"country_code": "US",
"telephone_number": "910-423-4233",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ASEMOTA",
"first_name": "OGIEMWONYI",
"middle_name": "ELEKHUOBA",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "9700454",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891066J",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.