Active NPI
Omo Imafidon, MOT, OTR
- Occupational Therapist
- Celina, TX
National Provider Identifier
1144645524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 114943
- Practice address
- 918 W Walnut St Unit 65
Celina, TX 75009-9402 - Phone
- (972) 991-6777
- NPI assigned
- Feb 21, 2014
- Last updated
- Aug 23, 2023
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 114943 | TX | Primary |
Addresses
Primary practice location
918 W Walnut St Unit 65
Celina, TX 75009-9402
Mailing address
918 W Walnut St Unit 65
Celina, TX 75009-9402
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 751189353 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Launchability | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Early Intervention Provider Agency
- Dallas, TX
- NPI 1124449913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1144645524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "918 W WALNUT ST UNIT 65",
"city": "CELINA",
"state": "TX",
"postal_code": "750099402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "918 W WALNUT ST UNIT 65",
"city": "CELINA",
"state": "TX",
"postal_code": "750099402",
"telephone_number": "972-991-6777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMAFIDON",
"first_name": "OMO",
"credential": "MOT, OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-21",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "114943",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "751189353",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Celina, TX
- Christopher G Hixon, D.O.
- Claire Hoffman
- Huffman Rehab PLLC (Joints In Motion Physical Therapy - Prosper)
- Ignite Alliance Group
- Julia Ileje
- Imovelle Care Services LLC
- Independence Chiropractic, LLC (Independence Chiropractic)
- Integrity Therapy Solutions, LLC
- Interventional Partners PLLC (Premier Foot & Ankle)
- J&B Medical Supply Co Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.