IGBAGBOLEKE MOBOLAJI
NPI 1609677780
Student in an Organized Health Care Education/Training Program in Salem, VA

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 24, 2025PECOS Enrolled

1900 ELECTRIC RD, SALEM, VA 24153(540) 776-4793 Get Directions Write a Review

NPPES record last updated: March 24, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Igbagboleke Mobolaji NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IGBAGBOLEKE MOBOLAJI (NPI 1609677780) is an individual student in an organized health care education/training program in Salem, Virginia and active in the NPI registry since March 2025. The provider is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609677780

Entity TypeIndividual

Primary Taxonomy390200000X

Provider Legal NameIGBAGBOLEKE MOBOLAJI

Location Address1900 ELECTRIC RDSalem, VA 24153-7474

Mailing Address1900 Electric RdSalem, VA 24153-7474

Phone(540) 776-4793

Sole ProprietorNo

Enumeration DateMarch 24, 2025

NPPES CertifiedMarch 23, 2025

✔ NPI 1609677780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1900 ELECTRIC RD, Salem, VA 24153

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Igbagboleke Mobolaji is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.