Active NPI
Okiemute Beatrice Omoru
- Pediatrics Physician
- Danville, PA
National Provider Identifier
1013706977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MT233875
- Practice address
- 16 Woodbine LN
Danville, PA 17821-8029 - Phone
- (570) 271-5600
- NPI assigned
- May 6, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MT233875 | PA | Primary |
Addresses
Primary practice location
16 Woodbine LN
Danville, PA 17821-8029
Mailing address
16 Woodbine LN
Danville, PA 17821-8029
Phone (570) 271-5600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250610003314 | PA | Order and Referring Only - Pediatric Medicine | 6002326865 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT233875 | PA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746489600000",
"number": "1013706977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 WOODBINE LN",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178218029",
"telephone_number": "570-271-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 WOODBINE LN",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178218029",
"telephone_number": "570-271-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMORU",
"first_name": "OKIEMUTE",
"middle_name": "BEATRICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-06",
"last_updated": "2025-05-06",
"certification_date": "2025-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MT233875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.