NPIMap

Individual provider Active NPI

Dolamu Olumide Bamidele Sokunbi, M.D.

  • Nephrology Physician
  • Nacogdoches, TX
National Provider Identifier
1942276001
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
J7203 Issued in TX
Practice address
626 Russell Blvd
Suite B
Nacogdoches, TX 75965-1246
Phone
(936) 552-7216
Fax
(936) 552-7274
NPI assigned
Feb 27, 2006
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X J7203 TX Primary

Addresses

Primary practice location

626 Russell Blvd
Suite B
Nacogdoches, TX 75965-1246

Mailing address

626 Russell Blvd
Suite B
Nacogdoches, TX 75965-1246
Phone (936) 552-7216

Other identifiers 2

IdentifierTypeStateIssuer
073BKOtherTXBCBS
113679803MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050906000654 TX Practitioner - Nephrology 1759313240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

626 Russell Blvd
B
Nacogdoches, TX 75965-1246
Phone (936) 552-7216

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
99.51
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Nacogdoches Nephrology, PA CurrentSince May 2, 1997 Accepting new patients
Piney Woods Orthopedics PastSince Sep 25, 2019 Accepting new patients

Locations

626 Russell Blvd
#B
Nacogdoches, TX 75965
Phone (936) 552-7216

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHGBAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CHGBAA/Endpoint/CHGBAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1942276001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 RUSSELL BLVD",
            "address_2": "SUITE B",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651246",
            "telephone_number": "936-552-7216",
            "fax_number": "936-552-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 RUSSELL BLVD",
            "address_2": "SUITE B",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651246",
            "telephone_number": "936-552-7216",
            "fax_number": "936-552-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOKUNBI",
        "first_name": "DOLAMU",
        "middle_name": "OLUMIDE BAMIDELE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "J7203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "073BK",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113679803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.