Individual provider Active NPI

Adetola Omotoso, RN,BSN

  • Registered Nurse
  • Houston, TX
National Provider Identifier
1255835005
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
934083 Issued in TX
Practice address
14105 Elmfield St
Houston, TX 77047-5047
Phone
(832) 417-1350
NPI assigned
Mar 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 934083 TX Primary

Addresses

Primary practice location

14105 Elmfield St
Houston, TX 77047-5047

Mailing address

2840 Shadowbriar Dr Apt 1318
Houston, TX 77077-3290
Phone (317) 657-9467

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)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
934083TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1255835005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 SHADOWBRIAR DR APT 1318",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770773290",
            "telephone_number": "317-657-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14105 ELMFIELD ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770475047",
            "telephone_number": "832-417-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOTOSO",
        "first_name": "ADETOLA",
        "credential": "RN,BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "934083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; 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.