CENTRAL CLINIC, PC – Hematology & Oncology Physician, NPI 1649469743

Hematology & Oncology Physician

CENTRAL CLINIC, PC is a healthcare provider. based in Jackson, Michigan. specializing in Hematology & Oncology Physician. The organization holds a License No. 4301042822 (MI). The NPI Number for CENTRAL CLINIC, PC is 1649469743

Main info

Organization

Name

CENTRAL CLINIC, PC

NPI

1649469743

Phone

(517) 787-8371

Address

603 LANSING AVE

Authorized Official

DR. DAVID O OLADELE-BANKOLE OWNER MD

Enumeration Date

15 October 2007

Last Update Date

27 September 2010

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience50

Completeness75

Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for CENTRAL CLINIC, PC

603, Lansing Avenue, Jackson, Jackson County, Michigan, 49202, United States
JACKSON, MI 492023209
Phone: (517) 787-8371
Fax: (517) 787-2639
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-02-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
O20110215000213	O	Clinic/Group Practice	MI	TBD

What to do next

No action required while the due date shows TBD.
Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49202)

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Reviews

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Frequently asked questions

Can I verify CENTRAL CLINIC, PC with an NPI only?

You can start verification with NPI 1649469743 for CENTRAL CLINIC, PC, then check state licensing separately.

Can I rely on CENTRAL CLINIC, PC being an active provider?

As of the registry snapshot, CENTRAL CLINIC, PC is marked active.

What taxonomy line describes CENTRAL CLINIC, PC?

For research purposes, treat CENTRAL CLINIC, PC as Hematology & Oncology Physician in this dataset. Clinical services aligned with this taxonomy classification.

Where should I expect CENTRAL CLINIC, PC on a map?

Expect Jackson, Michigan as a primary anchor for CENTRAL CLINIC, PC unless the record lists multiple sites.

Why does CENTRAL CLINIC, PC have multiple addresses?

2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.