Individual provider Active NPI

Oluwayemisi M. Ojemakinde, MD

  • Diagnostic Radiology Physician
  • Leesville, LA
National Provider Identifier
1972947166
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
303882 Issued in LA
Practice address
1020 W Fertitta Blvd
Leesville, LA 71446-4645
Phone
(337) 239-5148
NPI assigned
Apr 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X 303882 LA Primary

Addresses

Primary practice location

1020 W Fertitta Blvd
Leesville, LA 71446-4645

Mailing address

PO Box 1547
Sedalia, MO 65302-1547
Phone (660) 826-5960

Other identifiers 1

IdentifierTypeStateIssuer
2331221MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20180504001088 LA Practitioner - Diagnostic Radiology 3779887146 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1020 W Fertita Blvd
Leesville, LA 71446-4645
Phone (337) 239-5148

Hospital & facility affiliations

  • Byrd Regional Hospital Hospital, Leesville, LA, CCN 190164
  • Dequincy Memorial Hospital Hospital, Dequincy, LA, CCN 191307
  • Beauregard Memorial Hospital Hospital, Deridder, LA, CCN 190050
  • Lake Charles Memorial Hospital Hospital, Lake Charles, LA, CCN 190060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
303882LAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oluwayemisi Radiology LLC Multi-Specialty CurrentSince Jul 1, 2019 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Multi-Specialty CurrentSince Jul 1, 2018 Accepting new patients
CLHG-Acadian, LLC Multi-Specialty CurrentSince Jan 7, 2022 Accepting new patients
CLHG-Acadian LLC Multi-Specialty CurrentSince Jan 7, 2022 Accepting new patients

Locations

3501 Highway 190
Eunice, LA 70535
Phone (337) 580-7500

1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278

1501 Kings Hwy
Rm 1201
Shreveport, LA 71103
Phone (318) 675-4881

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

Organizations & group practices 4

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 6

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": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1972947166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653021547",
            "telephone_number": "660-826-5960",
            "fax_number": "660-826-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W FERTITTA BLVD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464645",
            "telephone_number": "337-239-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJEMAKINDE",
        "first_name": "OLUWAYEMISI",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "303882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2331221",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.