Individual provider Active NPI

Ogechi Nita Enyioko, FNP

  • Family Nurse Practitioner
  • Warren, MI
National Provider Identifier
1285191254
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704289385 Issued in MI
Practice address
30500 Van Dyke Ave
Warren, MI 48093-2195
Phone
(248) 325-7093
NPI assigned
Feb 26, 2019
Last updated
Feb 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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 4704289385 MI Primary

Addresses

Primary practice location

30500 Van Dyke Ave
Warren, MI 48093-2195

Mailing address

29714 Somerset Dr
Southfield, MI 48076-1871
Phone (248) 325-7093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190311001052 MI Practitioner - Nurse Practitioner 9739428632 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mdslivenow PLLCGroup PAC ID 7214323336, 14 clinicians

Practice addresses (Care Compare)

4100 Woodward Ave
Detroit, MI 48201-2173
Phone (313) 974-6533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Laz Medical Group PC CurrentSince May 4, 2023 Accepting new patients
Mdslivenow PLLC CurrentSince Feb 2, 2023 Accepting new patients
Michigan Family Medicine and Urgent Care CurrentSince Dec 14, 2023 Accepting new patients
Guided Care Center Current Accepting new patients
Senior Care Health Group PLLC CurrentSince Nov 1, 2025 Accepting new patients
Henry Ford Health System Past Accepting new patients

Locations

8542 N Canton Center Rd
Canton, MI 48187
Phone (313) 974-6533

4353 Maple St
Dearborn, MI 48126
Phone (313) 908-0004

16226 Grand River Ave
Detroit, MI 48227
Phone (313) 836-5490

20526 Plymouth Rd
Detroit, MI 48228
Phone (313) 273-3780

4100 Woodward Ave
Detroit, MI 48201
Phone (313) 449-7954

6531 W Michigan Ave
#C
Jackson, MI 49201
Phone (517) 750-3822

21701 W 11 Mile Rd
Ste 5
Southfield, MI 48076
Phone (248) 747-1690

Interoperability endpoints

  • Direct secure messaging: oenyioko389267@direct.hfhs.org

Organizations & group practices 8

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": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1285191254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29714 SOMERSET DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761871",
            "telephone_number": "248-325-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30500 VAN DYKE AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932195",
            "telephone_number": "248-325-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENYIOKO",
        "first_name": "OGECHI",
        "middle_name": "NITA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704289385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.