Individual provider Active NPI

Oliver Namyalo, APRN

  • Family Nurse Practitioner
  • Seville, OH
National Provider Identifier
1104792290
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LE-00059901 Issued in OH
Practice address
511 Giant TRL
Seville, OH 44273-8980
Phone
(216) 213-8855
NPI assigned
Oct 15, 2025
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LE-00059901 OH Primary

Addresses

Primary practice location

511 Giant TRL
Seville, OH 44273-8980

Mailing address

511 Giant TRL
Seville, OH 44273-8980
Phone (216) 213-8855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260508001943 OH Practitioner - Nurse Practitioner 1052889920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

PO Box
Lafayette, LA 70505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LE-00059901OHMDFamily Nurse Practitioner

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1104792290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 GIANT TRL",
            "city": "SEVILLE",
            "state": "OH",
            "postal_code": "442738980",
            "telephone_number": "216-213-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 GIANT TRL",
            "city": "SEVILLE",
            "state": "OH",
            "postal_code": "442738980",
            "telephone_number": "216-213-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMYALO",
        "first_name": "OLIVER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "LE-00059901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seville, OH

Sources for this page

Verify at the official NPI Registry.