Active NPI
Folake Adekunle, MD
- Student in an Organized Health Care Education/Training Program
- Texarkana, AR
National Provider Identifier
1942545736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3417 U of a Way
Texarkana, AR 71854-1419 - Phone
- (870) 779-6000
- Fax
- (870) 779-6050
- NPI assigned
- Dec 5, 2012
- Last updated
- Apr 9, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | AP140240 | TX | |
| Women's Health Nurse Practitioner | 363LW0102X | 421111 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
3417 U of a Way
Texarkana, AR 71854-1419
Mailing address
3417 U of a Way
Texarkana, AR 71854-1419
Phone (870) 779-6000
Other practice location 1
8785 W Bellfort St
Houston, TX 77031
Phone (713) 771-2292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03577593 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240910001567 | AR | Order and Referring Only - Family Practice | 1658514096 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 421111 | NY | MD | Women's Health Nurse Practitioner |
| AP140240 | TX | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Arkansas for Medical Sciences | Current | Accepting new patients | |
| University of Arkansas for Medical Sciences | Current | Accepting new patients |
Locations
3417 U of a Way
Texarkana, AR 71854
Phone (870) 779-6000
Interoperability endpoints
- fwimbish321604@direct.ochin.org
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.
-
- Family Medicine Physician
- El Dorado, AR
- NPI 1023795051
-
- Family Medicine Physician
- Texarkana, AR
- NPI 1215935234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712620800000",
"number": "1942545736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3417 U OF A WAY",
"city": "TEXARKANA",
"state": "AR",
"postal_code": "718541419",
"telephone_number": "870-779-6000",
"fax_number": "870-779-6050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3417 U OF A WAY",
"city": "TEXARKANA",
"state": "AR",
"postal_code": "718541419",
"telephone_number": "870-779-6000",
"fax_number": "870-779-6050"
}
],
"practiceLocations": [
{
"address_1": "8785 W Bellfort St",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "77031",
"country_code": "US",
"telephone_number": "713-771-2292",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ADEKUNLE",
"first_name": "FOLAKE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-05",
"last_updated": "2024-04-09",
"certification_date": "2024-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "TX",
"license": "AP140240",
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "NY",
"license": "421111",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03577593",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Texarkana, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.