Taiwo Olanike Adams, NURSE PRACTITIONER
Individual provider Active NPI Family Nurse Practitioner · Bloomington, CA
NPI 1942765151 · NPPES record last updated Sep 17, 2021
Key facts
- NPI
- 1942765151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95008108 (CA)
- Practice address
- 18651 Valley Blvd
Bloomington, CA 92316-1831 - Phone
- (909) 546-7520
- NPI assigned
- Feb 1, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240327002539 | CA | Order and Referring Only - Nurse Practitioner | 1254670953 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95008108 | CA | MD | Family Nurse Practitioner |
Interoperability endpoints
- taiwo.ige.p1@direct.chsica.nextgenshare.com
- taiwo.ige.p1@direct.scfhc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95008108 | CA | Yes |
Addresses
Primary practice location
18651 Valley Blvd
Bloomington, CA 92316-1831
Mailing address
18651 Valley Blvd
Bloomington, CA 92316-1831
Phone (909) 546-7520
Other names
- Nikki Nike Adams
Other providers in Bloomington, CA
- Hamza Abdallah
- Karina M Aceves
- Jack T Ackerman
- Act Healthcare Services
- Acts for Children
- Tammy Ahumada
- Robert John B Albino
- Martin Almeida
- Alpesh Patel DDS, Inc
- Derek Altherr
All providers in Bloomington, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.