Prestige Vintage Care

Primary specialty

Registered NurseTaxonomy code 163W00000X

Legal business name

PRESTIGE VINTAGE CARE

Practice address

4111 Great Forest CT
Humble, TX 77346-2489

Phone

(713) 269-5345

NPI assigned

Oct 9, 2024

Organization subpart

No

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

Authorized official

Name

Shoshanna Lynn Omobosoye, RN

Title

Owner/Administrator

Phone

(713) 491-0991

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1114746849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 GREAT FOREST CT",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773462489",
            "telephone_number": "713-269-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 GREAT FOREST CT",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773462489",
            "telephone_number": "713-269-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE VINTAGE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2025-09-11",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "OMOBOSOYE",
        "authorized_official_first_name": "SHOSHANNA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "713-491-0991",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "homehealth@prestigevintagecare.com",
            "affiliation": "N",
            "endpointDescription": "agency's email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4111 Great Forest Ct",
            "city": "Humble",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773462489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Registered Nurse in Humble, TX
• Providers in Humble, TX by specialty
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.