BOLAJI KEHINDE ADETIBA (NPI# 1568700979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568700979 |
| Entity Type | Individual |
| Full Name | BOLAJI KEHINDE ADETIBA |
| Credential | MSN-ANP |
| Practice Address |
9 Medical Pkwy Ste 308 Dallas TX 75234-7858 |
| Mailing Address |
Po Box 2932 Yuma AZ 85366-2401 |
| Practice Telephone | 9728887240 |
| Practice Fax Number | 9728887285 |
| Mailing Telephone | 9282764477 |
| Mailing Fax Number | 9282764481 |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2017-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
731957 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9 MEDICAL PKWY STE 308 |
| City | DALLAS |
| State | TX |
| Zip Code | 75234-7858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003814146 | Ketan P Patel | Internal Medicine | 9 Medical Pkwy, Ste 308, Dallas, TX 75234 | 2005-07-12 |
| 1144775891 | Liver Center of Texas, Pllc | Internal Medicine | 9 Medical Pkwy, Plaza 4 Ste 206, Dallas, TX 75234-7858 | 2016-08-23 |
| 1912312331 | Riya Medical Group, Pllc | Internal Medicine | 9 Medical Pkwy, Ste 308, Dallas, TX 75234-7855 | 2014-06-24 |
| 1093126153 | Kts Rehab LLC | Internal Medicine | 9 Medical Pkwy, Ste 308, Dallas, TX 75234-7858 | 2014-05-12 |
| 1033551312 | Dallas Medical Physician Group | Internal Medicine | 9 Medical Pkwy, Suite 207, Dallas, TX 75234-7851 | 2013-07-26 |
| 1780029132 | Arpita Amin | Physician Assistant | 9 Medical Pkwy, Suite # 308, Dallas, TX 75234-7858 | 2013-04-29 |
| 1669711594 | Iheart Amb-surg Dmc LLC | Clinic/Center | 9 Medical Pkwy, Ste 308, Dallas, TX 75234-7858 | 2013-02-13 |
| 1669727301 | Iheart Care Dmc, LLC | Internal Medicine | 9 Medical Pkwy, Suite 308, Dallas, TX 75234-7858 | 2012-07-18 |
| 1164717401 | Manojkumar A Dobariya | Family Medicine | 9 Medical Pkwy, Suite 308, Dallas, TX 75234-7858 | 2011-06-15 |
| 1699077180 | Aashka Medical Group Pllc | Clinic/Center | 9 Medical Pkwy, Plaza 4, Suite 308, Dallas, TX 75234-7858 | 2010-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912547175 | Emx Eye Care Management | Eyewear Supplier (Equipment, not the service) | 138 Senlac Drive, Suite 200, Farmers Branch, TX 75234 | 2020-01-15 |
| 1124597232 | Caleb Poe | Physical Therapist | 1775 Wittington Place, Ste. #175, Dallas, TX 75234 | 2018-11-19 |
| 1043790298 | Joseph M Satterfield | Physical Therapist | 1775 Wittington Place Ste. #175, Dallas, TX 75234 | 2018-08-17 |
| 1023507621 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 2702 Valwood Pkwy, Farmers Branch, TX 75234 | 2018-05-09 |
| 1821593385 | Farmers Branch Primary Care LLC | Family Medicine | 13000 Josey Lane Ste 100, Farmers Branch, TX 75234 | 2018-03-27 |
| 1487159349 | Kavitha Prasad | Dentist | 3030 Lbj Freeway, Suite 1400, Dallas, TX 75234 | 2018-03-23 |
| 1841793734 | Dedicated Hospice Care LLC | Hospice Care, Community Based | 2665 Villa Creek Dr #201, Dallas, TX 75234 | 2018-03-16 |
| 1811499387 | Lumincare Physician Group, Pa | Family Medicine | 2914 Valley View Lane, Farmers Branch, TX 75234 | 2018-03-01 |
| 1972014223 | Judith Johnson | Home Health Aide | 2828 Forest Ln Ste 1143, Dallas, TX 75234 | 2017-10-13 |
| 1780101642 | Godly Hospice and Palliative Care LLC | Hospice Care, Community Based | 2735 Villa Creek Dr Ste A260, Farmers Branch, TX 75234 | 2017-08-23 |
| Find all providers in zip 75234 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443132 | Rincy P Mathew | Nurse Practitioner | 10935 Estate Ln Ste 400, Dallas, TX 75238-5110 | 2020-09-24 |
| 1588279525 | Marquita Michelle Pickens | Nurse Practitioner | 6817 Historic Vw, Dallas, TX 75236-0109 | 2020-09-15 |
| 1407469125 | Ashley Johnson Nakwaasah | Nurse Practitioner | 14650 Landmark Blvd Apt 1508, Dallas, TX 75254-6932 | 2020-08-24 |
| 1881229359 | Laura Karmann | Nurse Practitioner | 1515 S Buckner Blvd Ste 141, Dallas, TX 75217-1794 | 2020-03-05 |
| 1659902120 | Alegntaye Yirdaw | Nurse Practitioner | 2709 S Buckner Blvd, Dallas, TX 75227-6904 | 2020-02-03 |
| 1154964047 | Jessica Maria Scarf | Nurse Practitioner | 13907 Montfort Dr Apt 2031, Dallas, TX 75240-7374 | 2019-10-23 |
| 1447893565 | Mallory Lynn Mcgroarty | Nurse Practitioner | 3500 Oak Lawn Ave Ste 760, Dallas, TX 75219-4308 | 2019-10-21 |
| 1720563539 | Heather Inkman Kinder | Nurse Practitioner | 16619 Vicarage Ct, Dallas, TX 75248-2227 | 2018-09-27 |
| 1760964100 | Amber Nicole Caruthers | Nurse Practitioner | 8060 Park Lane, Dallas, TX 75231 | 2018-09-01 |
| 1922594902 | Susan Markose | Nurse Practitioner | 3310 Anchor Ct, Dallas, TX 75219-2752 | 2018-07-02 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.