MEDICARE: COUNTY OF INGHAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	231158	OTHER	MI	PTAN

General Provider Information

NPI Number	:	1558928747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF INGHAM

Provider Business Mailing Address
First Line	:	PO BOX 30161
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48909-7661
Country	:	US
Telephone Number	:	517-887-4383
Fax Number	:	517-244-7174

Provider Business Practice Location Address
First Line	:	815 N FAIRVIEW AVE RM 100
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48912-3129
Country	:	US
Telephone Number	:	517-244-8019
Fax Number	:

Authorized Official
Title or Position	:	OA - MEDICAL HEALTH OFFICER
Name	:	ADENIKE TOLULUPE SHOYINKA
Credential	:	MD
Telephone Number	:	517-887-4466

Provider Enumeration Date	:	05/22/2019
Last Update Date	:	10/15/2025

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Directions to “COUNTY OF INGHAM ” Practice Location

Language	Start Address	Practice Location

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