DR. OLUSOLA OLASUPO ADEGOKE (NPI# 1619311586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619311586 |
| Entity Type | Individual |
| Full Name | DR. OLUSOLA OLASUPO ADEGOKE |
| Credential | MD MPH |
| Practice Address |
15290 Pennock Ln Apple Valley MN 55124-7163 |
| Mailing Address |
8170 33rd Ave S # Ms 21110q Minneapolis MN 55425-4516 |
| Practice Telephone | 9528538800 |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2020-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 59639 | MN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 535 Hospital Rd, New Richmond, WI 54017 | 7152433400 | 7152433416 |
| 2220 Riverside Ave, Minneapolis, MN 554541321 | 9528538800 |
| Street Address |
15290 PENNOCK LN |
| City | APPLE VALLEY |
| State | MN |
| Zip Code | 55124-7163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700857018 | Thomas Michael King | Family Medicine | 15290 Pennock Ln, Apple Valley, MN 55124-7163 | 2006-01-27 |
| 1053807719 | John Boettger | Physician Assistant | 15290 Pennock Ln, Apple Valley, MN 55124 | 2018-07-06 |
| 1437688538 | Zaynab Rasheed | Family Medicine | 15290 Pennock Ln, Apple Valley, MN 55124-7163 | 2017-06-12 |
| 1992236194 | Erica Lee Mahlum | Physician Assistant | 15290 Pennock Ln, Apple Valley, MN 55124-7163 | 2017-03-21 |
| 1902213366 | Kelly Fischer | Occupational Therapist | 15290 Pennock Ln, Apple Valley, MN 55124-7163 | 2014-07-17 |
| 1528483799 | Brita Emanuell Dahlquist | Physician Assistant | 15290 Pennock Ln, Apple Valley, MN 55124-7163 | 2014-02-25 |
| 1497018055 | Daniel E Stein | Family Medicine | 15290 Pennock Ln, Apple Valley, MN 55124-7163 | 2012-06-19 |
| 1386910479 | Tracy Jo Irons-dieterle | Nurse Practitioner | 15290 Pennock Ln, Apple Valley, MN 55124-7163 | 2012-03-22 |
| 1457631517 | Neil James Johnson | Dentist | 15290 Pennock Ln, Apple Valley, MN 55124-7163 | 2011-08-22 |
| 1558597377 | Sushant Nangrani | Family Medicine | 15290 Pennock Ln, Apple Valley, MN 55124 | 2009-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574672 | Carol Susan Elstad | Counselor | Mn Mental Health Clinics, 15160 Foliage Ave Suite 140, Apple Valley, MN 55124 | 2020-09-23 |
| 1629612569 | Gadaa Care Transportation | Non-emergency Medical Transport (VAN) | 7296 157th St W, Apple Valley, MN 55124 | 2019-11-04 |
| 1356831515 | Dustin W Seabolt | Hearing Instrument Specialist | 15071 Dunwood Trl, Apple Valley, MN 55124 | 2018-05-14 |
| 1639687189 | Dentalign P.a. | Clinic/Center | 15875 Emperor Avenue, Apple Valley, MN 55124 | 2018-01-18 |
| 1982126926 | Apex Family Chiropractic LLC | Chiropractor | 15678 Pilot Knob Road, Suite 120, Apple Valley, MN 55124 | 2017-07-12 |
| 1821523028 | Robin Marie Parker | Nurse Practitioner | 14135 Cedar Avenue South, Suite 100, Apple Valley, MN 55124 | 2017-04-25 |
| 1134578826 | Ellen Denise Jacobson | Dentist | 14682 Pennock Avenue South, Apple Valley, MN 55124 | 2016-06-03 |
| 1831568708 | Clearriver Inc. | Home Health | 13790 Elkhart Rd, Apple Valley, MN 55124 | 2015-09-21 |
| 1265826879 | Next Level Fitness Co | Public Health or Welfare | 14645 Felton Ct, 104, Apple Valley, MN 55124 | 2015-03-20 |
| 1568872216 | Jon Butala | Marriage & Family Therapist | 4300 W 147th St., Suite 204, Apple Valley, MN 55124 | 2014-05-04 |
| Find all providers in zip 55124 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427567759 | Abigail Amrine | Family Medicine | 16167 Siskiyou Rd Ste A, Apple Valley, CA 92307-0837 | 2017-09-29 |
| 1518494541 | Empire Health Systems | Family Medicine | 15995 Tuscola Rd Ste 203, Apple Valley, CA 92307-2159 | 2017-05-22 |
| 1396147419 | Aaa Family Medical Group | Family Medicine | 15995 Tuscola Rd Ste 202, Apple Valley, CA 92307 | 2014-09-19 |
| 1295031052 | Desert Valley Medical Group, Inc. | Family Medicine | 19181 Town Center Dr, Apple Valley, CA 92308-8989 | 2011-01-26 |
| 1346550555 | Apple Valley Medical Clinic, Ltd. | Family Medicine | 15100 Galaxie Ave, Apple Valley, MN 55124 | 2010-10-21 |
| 1114235744 | Kenneth Grier | Family Medicine | 18564 Us Highway 18 Ste 101, Apple Valley, CA 92307-2320 | 2010-09-16 |
| 1831416742 | Bashar Mousa Shahatit | Family Medicine | 19341 Bear Valley Rd Ste 104, Apple Valley, CA 92308-5152 | 2010-05-02 |
| 1225232382 | John F Kuettner | Family Medicine | 13545 Hershey Ct, Apple Valley, MN 55124 | 2007-06-13 |
| 1912056177 | Jaime Cristobal David | Family Medicine | 18419 Outer Highway 18, Suite #6, Apple Valley, CA 92307 | 2007-01-09 |
| 1841353869 | Dan Vasile | Family Medicine | 18522 Us Highway 18 Ste 102, Apple Valley, CA 92307-2321 | 2006-12-19 |
| Find all providers in APPLE VALLEY | ||||
| City | APPLE VALLEY |
| Zip Code | 55124 |
Please comment or provide details below to improve the information on DR. OLUSOLA OLASUPO ADEGOKE.
| 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.