Trident Lake Health Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

TRIDENT LAKE HEALTH INC

Practice address

4140 E Bethena St
Gilbert, AZ 85295-0321

Phone

(562) 221-3960

NPI assigned

Mar 24, 2025

Last updated

Jun 25, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Olayinka Adeoya, PTNPI 1659885697

Title

Ceo

Phone

(562) 221-3960

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Olayinka Ifeoluwa Adeoya, PT

  • Physical Therapist
  • Bedford, IN
  • NPI 1659885697
  NPD Authorized official

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782345600000",
    "number": "1912708173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 E BETHENA ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852950321",
            "telephone_number": "562-221-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 E BETHENA ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852950321",
            "telephone_number": "562-221-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT LAKE HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-24",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A",
        "authorized_official_last_name": "ADEOYA",
        "authorized_official_first_name": "OLAYINKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-221-3960",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.