Olufunmilola Adisa, MD, MPH
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Kalamazoo, MI
NPI 1992648851 · NPPES record last updated Apr 21, 2026
Key facts
- NPI
- 1992648851
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- 4351055854 (MI)
- Practice address
- 1000 Oakland Dr
Kalamazoo, MI 49008-1282 - Phone
- (269) 337-4600
- NPI assigned
- Apr 13, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260507002602 | MI | Order and Referring Only - Family Practice |
1355819327 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4351055854 | MI | MD | Student in an Organized Health Care Education/Training Program |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4351055854 | MI | Yes |
Addresses
Primary practice location
1000 Oakland Dr
Kalamazoo, MI 49008-1282
Mailing address
1000 Oakland Dr
Kalamazoo, MI 49008-1282
NPI Registry JSON
{
"created_epoch": "1776038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776729600000",
"number": "1992648851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 OAKLAND DR",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490081282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 OAKLAND DR",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490081282",
"telephone_number": "269-337-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADISA",
"first_name": "OLUFUNMILOLA",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-13",
"last_updated": "2026-04-21",
"certification_date": "2026-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4351055854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
- Gabriella Adams
- Jonas Vladas Adams
- Lissa Adams
- Reghan Adams
- Ryan L Adams
- Michael Lee Adix II
- Carla Adkison-Bradley
- Adl Home Care Inc
- Adl Home Care Kalamazoo, Inc.
- Maham Adnan
All providers in Kalamazoo, MI · Student in an Organized Health Care Education/Training Program in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2026. 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.