Maame Efua Sompa Otabil, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2018034807 Issued in MO

Practice address

2716 W Republic Rd
Springfield, MO 65807-3901

Phone

(417) 881-8812

NPI assigned

Apr 2, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Maame Efua Sompa Otabil-Nelson Other name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454
  NPD

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1083009484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 W REPUBLIC RD",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658073901",
            "telephone_number": "417-881-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 W REPUBLIC RD",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658073901",
            "telephone_number": "417-881-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTABIL",
        "first_name": "MAAME EFUA",
        "middle_name": "SOMPA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2018034807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAAME EFUA",
            "last_name": "OTABIL-NELSON",
            "middle_name": "SOMPA",
            "credential": "M.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Osceola Family Medicine LLC
• Osmond Hearing Centers
• Clifford Dean Osten
• Kami L Oster, P.A.
• Jill M. Oswalt, M.A., CCC-SLP
• Jennifer A. Ott, FNP
• Matthew C Otte, PHARMD
• Bruce Adam Ottenberg, PLPC
• Chase Otto
• Steven M Otto, MD

• Family Medicine Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.

Verify at the official NPI Registry.