Individual provider Active NPI

Temidayo A Adelekun, MD

  • Internal Medicine Physician
  • Kings Mountain, NC
National Provider Identifier
1962497537
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200001048 Issued in NC
Practice address
502 W King St
LL#20
Kings Mountain, NC 28086-3362
Phone
(704) 730-8461
Fax
(704) 730-8349
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200001048 NC Primary

Addresses

Primary practice location

502 W King St
LL#20
Kings Mountain, NC 28086-3362

Mailing address

502 W King St
LL#20
Kings Mountain, NC 28086-3362
Phone (704) 730-8461

Other identifiers 1

IdentifierTypeStateIssuer
891276GMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040723000283 NC Practitioner - Internal MedicinePractitioner - Family Practice 9436139094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

407 W King St
Suite 2
Kings Mountain, NC 28086-3393
Phone (704) 730-8461

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Shelby, NC, CCN 347317
  • Bayada Home Health Care Inc Home health agency, Gastonia, NC, CCN 347326
  • Atrium Health Cleveland Hospital, Shelby, NC, CCN 340021
  • Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23102SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Clinic and Urgent Care PLLC CurrentSince Jan 1, 2007 Accepting new patients
Cogent Healthcare of North Carolina, PC Internal Medicine Past Accepting new patients
Gaurang Palikh, MD, PC PastSince Jul 2, 2016 Accepting new patients

Locations

407 W King St
Ste 2
Kings Mtn, NC 28086
Phone (704) 730-8461

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12246/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1962497537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W KING ST",
            "address_2": "LL#20",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280863362",
            "telephone_number": "704-730-8461",
            "fax_number": "704-730-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W KING ST",
            "address_2": "LL#20",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280863362",
            "telephone_number": "704-730-8461",
            "fax_number": "704-730-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADELEKUN",
        "first_name": "TEMIDAYO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200001048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891276G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Mountain, NC

Sources for this page

Verify at the official NPI Registry.