Active NPI
Gbemisola Kikelomo Odeseye, DPT
- Physical Therapist
- Burleson, TX
National Provider Identifier
1154768943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 24478
- Practice address
- 301 Huguley Blvd
Burleson, TX 76028-7506 - Phone
- (410) 802-0730
- NPI assigned
- Jun 3, 2013
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 24478 | MD | Primary |
Addresses
Primary practice location
301 Huguley Blvd
Burleson, TX 76028-7506
Mailing address
920 McKavett Dr
Burleson, TX 76028-9302
Phone (410) 802-0730
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CP014752T | Other | TX | TEXAS BOARD OF PHYSICAL THERAPY |
| 24478 | Other | MD | BOARD OF PHYSICAL THERAPY, MARYLAND |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24478 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1154768943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 MCKAVETT DR",
"city": "BURLESON",
"state": "TX",
"postal_code": "760289302",
"telephone_number": "410-802-0730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 HUGULEY BLVD",
"city": "BURLESON",
"state": "TX",
"postal_code": "760287506",
"telephone_number": "410-802-0730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODESEYE",
"first_name": "GBEMISOLA",
"middle_name": "KIKELOMO",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-03",
"last_updated": "2025-09-11",
"certification_date": "2022-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "24478",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS BOARD OF PHYSICAL THERAPY",
"identifier": "CP014752T",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHYSICAL THERAPY, MARYLAND",
"identifier": "24478",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burleson, TX
Sources for this page
- 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.