CMS-1500 Box 24J / 33a • NPI
1669985818
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
163WH0200X
CMS-Certified Home Health Care & Skilled Nursing Agency
Box 32 Service Location & ZIP+4
7539 COPPER KETTLE, CONVERSE, TX, 78109-3936
✓ 9-Digit EDI 837 ZIP+4 (78109-3936)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1669985818 (IBIYEMI SAFURAT ADEBIYI, Registered Nurse/Adm) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1669985818 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | IBIYEMI SAFURAT ADEBIYI, Registered Nurse/Adm |
| Plain-English Specialty | CMS-Certified Home Health Care & Skilled Nursing Agency NUCC Code: 163WH0200X (Registered Nurse, Home Health) |
| Certifying / Licensing Body | CMS Home Health Conditions of Participation / CHAP / ACHC |
| Practice Location Address | 7539 COPPER KETTLE, CONVERSE, TX, 78109-3936 |
| Practice Telephone / Fax | Tel: (281) 794-3546 |
| Administrative Mailing Address | 7539 COPPER KETTLE, CONVERSE, TX, 78109-3936 |
| Enumeration & Last Sync | Enumerated: 2017-11-09 | CMS Record Updated: 2017-11-09 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (163WH0200X)
What Does Taxonomy Code 163WH0200X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 163WH0200X translates to:
"CMS-Certified Home Health Care & Skilled Nursing Agency"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (IBIYEMI SAFURAT ADEBIYI, Registered Nurse/Adm)
Typical CPT / Diagnostic Procedures:- In-Home Skilled Nursing Wound Care, Ostomy & Catheter Management
- Home Intravenous Antibiotic Infusion (OPAT) & Post-Stroke Rehabilitation
- Home Infusion Antimicrobials, Anticoagulants & Insulin Titration
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
163WH0200X — Registered Nurse, Home HealthPlain English: CMS-Certified Home Health Care & Skilled Nursing Agency | State: TX | License: 905073 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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