JOHN A ADENIYI (NPI# 1306920756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306920756 |
| Entity Type | Individual |
| Full Name | JOHN A ADENIYI |
| Credential | M.D., F.A.C.S. |
| Practice Address |
527 Medical Park Dr Ste 501 Bridgeport WV 26330 |
| Mailing Address |
Po Box 890 Bridgeport WV 26330-0890 |
| Practice Telephone | 3048423993 |
| Practice Fax Number | 3048424083 |
| Mailing Telephone | 3048423993 |
| Mailing Fax Number | 3048424083 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2018-05-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
WV21293 | WV | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
WV21293 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810000654 | 05 | |
| WV | BCBS | 001719007 | 01 |
| WV | RR MC | P00093109 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 327 Medical Park Dr, Bridgeport, WV 263309006 | 6813421000 |
| Street Address |
527 MEDICAL PARK DR STE 501 |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460918 | Jordan Nicole Kesler | Nurse Practitioner | 527 Medical Park Dr Ste 501, Bridgeport, WV 26330-9010 | 2020-09-02 |
| 1750925202 | Janie Tennis Youssef | Nurse Practitioner | 527 Medical Park Dr Ste 501, Bridgeport, WV 26330-9010 | 2019-10-28 |
| 1972025732 | Rachel Pickrell | Surgery | 527 Medical Park Dr Ste 501, Bridgeport, WV 26330-9010 | 2017-07-13 |
| 1730592353 | United Vascular & Vein Center Pllc | Surgery | 527 Medical Park Dr Ste 501, Bridgeport, WV 26330 | 2014-06-11 |
| 1265519680 | Daniel James Merenda | Otolaryngology | 527 Medical Park Dr Ste 501, Bridgeport, WV 26330-9010 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972025732 | Rachel Pickrell | Surgery | 527 Medical Park Dr Ste 501, Bridgeport, WV 26330-9010 | 2017-07-13 |
| 1730592353 | United Vascular & Vein Center Pllc | Surgery | 527 Medical Park Dr Ste 501, Bridgeport, WV 26330 | 2014-06-11 |
| 1366759227 | United Hospital Center | Surgery | 916 W Main St, Bridgeport, WV 26330-1651 | 2010-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154961852 | Usa Vein Clinics of Morgantown Pllc | Surgery | 1010 Suncrest Towne Centre Drive, Morgantown, WV 26505-0000 | 2020-01-10 |
| 1740749928 | Foot and Ankle Clinic of The Virginias Inc | Surgery | 4141 Teays Valley Rd, Hurricane, WV 25526-9772 | 2019-03-18 |
| 1104318625 | Mountain State Vascular, Inc. | Surgery | 121 George Street, Beckley, WV 25801 | 2018-05-31 |
| 1538661848 | East Mountain Health Physicians, Inc. | Surgery | 1000 Tavern Rd Ste 200, Martinsburg, WV 25401-2853 | 2018-03-02 |
| 1861992174 | Usa Vein Clinics of West Virginia Pllc | Surgery | 1010 Suncrest Towne Centre, Morgantown, WV 26505 | 2018-02-14 |
| 1922230218 | Beckley Vascular Associates & Vein Care Institute,pllc | Surgery | 120 George Street, Beckley, WV 25801-2608 | 2009-08-20 |
| 1154581973 | Maryland Surgical Care PC | Surgery | 710 Somerset Blvd Ste 103, Charles Town, WV 25414-4998 | 2008-06-16 |
| 1790731503 | Wheeling Heart Institute Inc | Surgery | 1021 Mt Dechantal Road, Wheeling, WV 26003 | 2006-05-25 |
| 1568450245 | Vardhan Reddy | Surgery | 651 Colliers Way Ste 408, Weirton, WV 26062-5055 | 2005-10-07 |
| 1679567325 | Randall V Lester | Surgery | 510 Cherry St, Suite 206, Bldg A, Bluefield, WV 24701-3338 | 2005-09-08 |
| Find all providers with the same taxonomy | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
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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.