Individual provider Active NPI

Mayowa Olorunsola, DC

  • Chiropractor
  • Cypress, TX
National Provider Identifier
1003648940
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16090 Issued in TX
Practice address
13611 Skinner Rd Ste 120
Cypress, TX 77429-2797
Phone
(803) 399-0707
NPI assigned
Aug 19, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 16090 TX Primary

Addresses

Primary practice location

13611 Skinner Rd Ste 120
Cypress, TX 77429-2797

Mailing address

13611 Skinner Rd Ste 120
Cypress, TX 77429-2797
Phone (803) 399-0707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241024002993 TX Practitioner - Chiropractic 2668905944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13611 Skinner Rd
Suite 120
Cypress, TX 77429-2797
Phone (832) 653-7875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16090TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Olorunsola Family Chiropractic PLLC Chiropractor CurrentSince Oct 2, 2024 Accepting new patients

Locations

13611 Skinner Rd
Ste 120
Cypress, TX 77429
Phone (803) 399-0707

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1003648940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13611 SKINNER RD STE 120",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774292797",
            "telephone_number": "803-399-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13611 SKINNER RD STE 120",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774292797",
            "telephone_number": "803-399-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLORUNSOLA",
        "first_name": "MAYOWA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "16090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.