Individual provider Active NPI

Grace Oseiwe Oboh

  • Family Nurse Practitioner
  • Champaign, IL
National Provider Identifier
1194576793
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209030000 Issued in IL
Practice address
1801 W Windsor Rd
Champaign, IL 61822-6217
Phone
(217) 366-1200
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 209030000 IL Primary

Addresses

Primary practice location

1801 W Windsor Rd
Champaign, IL 61822-6217

Mailing address

101 W University Ave
Champaign, IL 61820-3981
Phone (217) 366-8130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240930000348 IL Practitioner - Nurse Practitioner 5294266417 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209030000ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jan 9, 2025 Accepting new patients
Christie Clinic, PLLC Nurse Practitioner CurrentSince Jul 22, 2024 Accepting new patients

Locations

101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255

1801 W Windsor Rd
Champaign, IL 61822
Phone (217) 366-5434

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Interoperability endpoints

  • Direct secure messaging: gobohaprn413543@carlehiedirect.net

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": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1194576793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-366-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W WINDSOR RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226217",
            "telephone_number": "217-366-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBOH",
        "first_name": "GRACE",
        "middle_name": "OSEIWE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209030000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.