NPIMap

Individual provider Active NPI

Theresa Okoro, CNM

  • Obstetrics Physician
  • Las Vegas, NM
National Provider Identifier
1235247461
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
R27113 Issued in NM
Practice address
105 Mills Ave Ste 200
105 Mills Ave. Ste. 200
Las Vegas, NM 87701-4169
Phone
(505) 454-1109
Fax
(505) 454-1779
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X R27113 NM Primary

Addresses

Primary practice location

105 Mills Ave Ste 200
105 Mills Ave. Ste. 200
Las Vegas, NM 87701-4169

Mailing address

105 Mills Ave Ste 200
105 Mills Ave. Ste. 200
Las Vegas, NM 87701-4169
Phone (505) 454-1109

Other identifiers 1

IdentifierTypeStateIssuer
49225022MedicaidNM

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
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
R27113NMMDObstetrics Physician

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8441/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235247461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MILLS AVE STE 200",
            "address_2": "105 MILLS AVE. STE. 200",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014169",
            "telephone_number": "505-454-1109",
            "fax_number": "505-454-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MILLS AVE STE 200",
            "address_2": "105 MILLS AVE. STE. 200",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014169",
            "telephone_number": "505-454-1109",
            "fax_number": "505-454-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKORO",
        "first_name": "THERESA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NM",
            "license": "R27113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49225022",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.