Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shola Obiku

Individual provider Registered Nurse · NPI 1790586394

Shola Obiku is a Nurse Practitioner in Enfield, Connecticut. Qualified in 2024, 2 years ago. Practices with Impact Physician Group Massachusetts PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
2
Licensed in
MA
In the registry since
2025
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

40 Foxcroft Rd
Enfield, CT 06082-2463
Phone: (413) 234-5556
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 2336642 (MA)

Record details

NPI number1790586394
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 20, 2025
Last updated in NPPESMarch 20, 2025
Certification dateMarch 20, 2025
Mailing address40 Foxcroft Rd, Enfield, CT 06082-2463

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Impact Physician Group Massachusetts Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Enfield