NPIMap

Individual provider Active NPI

Yemisi Aderemi Oduwole, M.D.

  • Family Medicine Physician
  • Midland, TX
National Provider Identifier
1306460563
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BP10072522 Issued in TX
Practice address
301, North N Street
Midland, TX 79701-6404
Phone
(432) 620-5800
NPI assigned
Jun 3, 2020
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X BP10072522 TX Primary

Addresses

Primary practice location

301, North N Street
Midland, TX 79701-6404

Mailing address

301, North N Street
Midland, TX 79701-6404
Phone (432) 620-5800

Other names 1

  • Yemisi Aderemi Odusoga Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230602000819 TX Practitioner - Family Practice 8729404694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Big Bend Medical GroupGroup PAC ID 2163326281, 46 clinicians

Practice addresses (Care Compare)

1608 W FM
Big Spring, TX 79720-4113

1608 W FM 700
Big Spring, TX 79720-4113

520 E 6TH St
Odessa, TX 79761-4527
Phone (432) 582-8535

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Hospitalist Services of Texas PLLC CurrentSince Aug 8, 2023 Accepting new patients
Comprehensive Hospitalist Services of Texas PLLC CurrentSince Aug 8, 2023 Accepting new patients
Big Bend Medical Group CurrentSince Oct 16, 2024 Accepting new patients
Big Bend Medical Group Family Medicine CurrentSince Oct 16, 2024 Accepting new patients
Odessa Texas Hospital Company LLC Past Accepting new patients
Odessa Regional Hospital LP Past Accepting new patients

Locations

1608 W FM 700
Ste C
Big Spring, TX 79720
Phone (432) 263-7700

520 E 6th St
Odessa, TX 79761
Phone (432) 332-0929

7101 Eastridge Rd
Odessa, TX 79765
Phone (432) 550-0048

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1306460563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301, NORTH N STREET",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797016404",
            "telephone_number": "432-620-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301, NORTH N STREET",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797016404",
            "telephone_number": "432-620-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUWOLE",
        "first_name": "YEMISI",
        "middle_name": "ADEREMI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10072522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YEMISI",
            "last_name": "ODUSOGA",
            "middle_name": "ADEREMI",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.