Olutoyosi Ogunkua

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

2023-01259 Issued in NC

Practice address

3735 Glenlake Dr Ste 250
Charlotte, NC 28208-6866

Phone

(704) 749-5800

Fax

(704) 626-3237

NPI assigned

Apr 23, 2012

Last updated

May 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, NC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Providence Anesthesiology Associates, P.a.

  • Anesthesiology Physician
  • Charlotte, NC
  • NPI 1396739884

  Multi-Specialty

  Medicare reassignment NPD
• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566

  Multi-Specialty

  Medicare reassignment NPD
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1922366350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "469-291-3369",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3735 GLENLAKE DR STE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282086866",
            "telephone_number": "704-749-5800",
            "fax_number": "704-626-3237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753907201",
            "country_code": "US",
            "telephone_number": "214-648-6400",
            "fax_number": "214-648-5461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGUNKUA",
        "first_name": "OLUTOYOSI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "R1429",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2023-01259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Oglesby, OTR/L
• Sherabiah J Oglesby, LCSW
• Emily Short Ogletree, MD
• Natalie Oguich, PA-C
• Modupe Abidayo Cassandra Ogunjimi-Popoola, MD
• Abosede Ogunro, LCSWA
• Ada Tolutope Ogunsiakan, MD
• Tosin Ogunsiakan, MD
• Ben O Ogunwale, M.D.
• Michelle D Ogunwale, PA-C

• Anesthesiology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Anesthesiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.