NPIMap

Individual provider Active NPI

Adetokunbo Olusola Ladipo, MD

  • Internal Medicine Physician
  • Anniston, AL
National Provider Identifier
1972601607
Registry record updated Aug 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
23571 Issued in AL
Practice address
1306 Leighton Ave.
Anniston, AL 36207
Phone
(256) 236-3031
Fax
(256) 236-3202
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2009

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 23571 AL Primary

Addresses

Primary practice location

1306 Leighton Ave.
Anniston, AL 36207

Mailing address

P.O. Box 1541
Anniston, AL 36202
Phone (256) 236-3031

Other identifiers 5

IdentifierTypeStateIssuer
109509MedicaidAL
1417168485OtherALOMNI CLINIC GROUP NPI
1326259300OtherALOMNI CLINIC OF SLYACAUGA
009938730MedicaidAL
051517112MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20090709000446 AL Practitioner - Internal Medicine 6709938574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1306 Leighton Ave
Anniston, AL 36207-4614
Phone (256) 236-3031

Hospital & facility affiliations

  • Amedisys Home Health of Anniston Home health agency, Anniston, AL, CCN 017305
  • Enhabit Home Health Home health agency, Hoover, AL, CCN 017009
  • Northeast Alabama Regional Medical Center Hospital, Anniston, AL, CCN 010078
  • Coosa Valley Medical Center Hospital, Sylacauga, AL, CCN 010164

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23571ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medmark Treatment Centers of Alabama, Inc. CurrentSince Dec 26, 2021 Accepting new patients
Omni Clinic PastSince Oct 3, 2000 Accepting new patients
Southern Medical Group, Inc Past Accepting new patients
The Health Care Authority of the City of Anniston Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15682/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251244800000",
    "number": "1972601607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1541",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "36202",
            "telephone_number": "256-236-3031",
            "fax_number": "256-236-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 LEIGHTON AVE.",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "36207",
            "telephone_number": "256-236-3031",
            "fax_number": "256-236-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADIPO",
        "first_name": "ADETOKUNBO",
        "middle_name": "OLUSOLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "23571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109509",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMNI CLINIC GROUP NPI",
            "identifier": "1417168485",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMNI CLINIC OF SLYACAUGA",
            "identifier": "1326259300",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009938730",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051517112",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anniston, AL

Sources for this page

Verify at the official NPI Registry.