DR. OLUSEYI FADEGBOLA OGUNDIMU (NPI# 1700016250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700016250 |
| Entity Type | Individual |
| Full Name | DR. OLUSEYI FADEGBOLA OGUNDIMU |
| Other Name | DR. OLUWASEYI FADEGBOLA OGUNDIMU |
| Credential | M.D. |
| Practice Address |
661 Fisher Dr Sullivan MO 63080-1533 |
| Mailing Address |
190 Industrial Dr Festus MO 63028-4133 |
| Practice Telephone | 5738603000 |
| Practice Fax Number | 5738603004 |
| Mailing Telephone | 6367772245 |
| Mailing Fax Number | 6367772208 |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2014-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
2014010100 | MO | Allopathic & Osteopathic Physicians |
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
4301103019 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1700016250 | 05 |
| Street Address |
661 FISHER DR |
| City | SULLIVAN |
| State | MO |
| Zip Code | 63080-1533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669896650 | Lindsay Nicole Arnette | Physical Therapist | 940 Mattox Drive, Meramec Nursing Center, Sullivan, MO 63080 | 2014-02-11 |
| 1407099500 | Victorian Manor of Sullivan | Assisted Living Facility | 1250 East Springfield Rd, Sullivan, MO 63080 | 2009-04-20 |
| 1578729992 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 123 Progress Parkway, Sullivan, MO 63080 | 2008-08-05 |
| 1386826089 | Sellers Family Chiropractic PC | Chiropractor | 405 Wal Mart Drive, Sullivan, MO 63080 | 2007-12-04 |
| 1740495282 | Tasha Marie Rodriguez | Physical Therapist | 107 Congress Dr., Sullivan, MO 63080 | 2007-05-10 |
| 1033261649 | Clyde William Sellers II | Chiropractor | 405 Walmart Dr., Sullivan, MO 63080 | 2007-01-17 |
| 1407954209 | Sara Skidmore | Occupational Therapist | 2022 Phoenix Drive, Sullivan, MO 63080 | 2006-09-20 |
| 1083724116 | Sharon A Titter | Physical Therapist | 107 Progress Dr, Sullivan, MO 63080 | 2006-08-30 |
| 1437135571 | Thanh Duy Vo | Pediatrics | 486 N Church St, Sullivan, MO 63080 | 2005-12-20 |
| 1508849316 | Air Evac Ems Inc | Ambulance | 673 Sappington Bridge Rd, Sullivan, MO 63080 | 2005-11-25 |
| Find all providers in zip 63080 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679088900 | Midwest Pain Management Clinic LLC | Anesthesiology | 1011 Old Olive Way Apt 403, Creve Coeur, MO 63141-5959 | 2017-12-08 |
| 1235579749 | Nicki D Rippeteau | Anesthesiology | 4606 E 184th St, Belton, MO 64012-8323 | 2013-06-28 |
| 1518217322 | Advanced Anesthesia and Pain Management, LLC | Anesthesiology | 12805 Topping Woods Estate Drive, St. Louis, MO 63131 | 2012-09-19 |
| 1265794911 | Regeneration Orthopedics, LLC | Anesthesiology | 6 Mcbride & Son Center Dr., Ste 204, Chesterfield, MO 63005 | 2012-06-08 |
| 1265727572 | Rebecca A Sanders | Anesthesiology | 1002 Mcintosh Cir Ste 6, Joplin, MO 64804-3600 | 2011-06-15 |
| 1457655748 | Melrich Inc | Anesthesiology | 625 Cannonbury Dr, Saint Louis, MO 63119-5312 | 2010-12-31 |
| 1467640235 | Shavonne L. Danner, M.d., L.L.C. | Anesthesiology | 2525 Glenn Henden Dr, Liberty, MO 64068 | 2007-10-05 |
| 1225171648 | Benjamin A Lampert | Anesthesiology | 1730 E Portland St, Springfield, MO 65804-1311 | 2007-02-15 |
| 1972651578 | Advanced Pain Specialists, Inc. | Anesthesiology | 7510 Big Bend Blvd, Saint Louis, MO 63119-2104 | 2007-01-08 |
| 1750441374 | James M. Sturm | Anesthesiology | 856 Waterbury Falls Dr Ste 100, O Fallon, MO 63368-2219 | 2006-12-12 |
| Find all providers with the same taxonomy | ||||
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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.