Individual provider Active NPI

Emmanuel Ajibola Okeowo, CRNA

  • Certified Registered Nurse Anesthetist
  • Albuquerque, NM
National Provider Identifier
1245109909
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
89757 Issued in NM
Practice address
6709 Academy Rd NE Ste a
Albuquerque, NM 87109-3363
Phone
(469) 767-1828
NPI assigned
Oct 31, 2025
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 89757 NM Primary

Addresses

Primary practice location

6709 Academy Rd NE Ste a
Albuquerque, NM 87109-3363

Mailing address

6709 Academy Rd NE Ste a
Albuquerque, NM 87109-3363
Phone (469) 767-1828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13500 Powers CT
Fort Myers, FL 33912-4503

PO Box
Dallas, TX 75222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1761868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1245109909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6709 ACADEMY RD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093363",
            "telephone_number": "469-767-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6709 ACADEMY RD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093363",
            "telephone_number": "469-767-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEOWO",
        "first_name": "EMMANUEL",
        "middle_name": "AJIBOLA",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-31",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "89757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.