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Active NPI 1083085674 Individual Practitioner Female Practitioner

Ibiyemi Omole

Licensed Practical Nurse • Canton, MI

Professional Overview & Biography Verified Profile Summary

Ibiyemi Omole is a registered healthcare professional specializing in Licensed Practical Nurse in Canton, MI. Practice services are available at 6223 N CANTON CENTER RD STE 201 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6223 N Canton Center Rd Ste 201

Canton, MI 481872696

Telephone 7348446533
Fax 7346675079
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Canton, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.0 Yrs
Regional Practice Density
96 Specialists

Practicing in Canton, MI (4550 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License MI 4703113310

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
4360685 (MI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

39 Associated Practitioners
Elizabeth Muli

Licensed Practical Nurse

NPI 1023576113
Andrea Mccormick

Registered Nurse

NPI 1033713367
Michelle Onwenu

Licensed Practical Nurse

NPI 1104227958
Afusat Dallas , LPN

Licensed Practical Nurse

NPI 1114352911

Licensed Practical Nurse

Michael Wade

Licensed Practical Nurse

NPI 1114583127
Jetrude Ahiwe , LPN

Licensed Practical Nurse

NPI 1154153484

Licensed Practical Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 08, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location October 08, 2015

Registered at 6223 N CANTON CENTER RD STE 201, CANTON, MI 481872696 (Tel: 7348446533)

📍
Updated Business Mailing Address October 08, 2015

Registered at 6223 N CANTON CENTER RD STE 201, CANTON, MI 481872696 (Tel: 7348446533)

👤
Provider Name / Credentials Updated October 08, 2015

Recorded as IBIYEMI OMOLE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 08, 2015

Licensed Practical Nurse (License #4703113310 in MI)

🟢
Initial NPI Registration & Enumeration October 08, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1083085674
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 08, 2015
Last Update: October 08, 2015
Sole Proprietor: No

Mailing Address

6223 N Canton Center Rd Ste 201

Canton, MI 481872696

Phone: 7348446533

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.