Individual provider Active NPI

Moradeke Adebukola Taiwo

  • Licensed Vocational Nurse
  • Fate, TX
National Provider Identifier
1356842330
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
231077 Issued in TX
Practice address
542 Laurel LN
Fate, TX 75087-9289
Phone
(214) 235-6444
NPI assigned
Feb 23, 2018
Last updated
Feb 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 231077 TX Primary

Addresses

Primary practice location

542 Laurel LN
Fate, TX 75087-9289

Mailing address

542 Laurel LN
Fate, TX 75087-9289
Phone (214) 235-6444

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

State licenses

LicenseStateTypeSpecialty
231077TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1356842330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 LAUREL LN",
            "city": "FATE",
            "state": "TX",
            "postal_code": "750879289",
            "telephone_number": "214-235-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 LAUREL LN",
            "city": "FATE",
            "state": "TX",
            "postal_code": "750879289",
            "telephone_number": "214-235-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAIWO",
        "first_name": "MORADEKE",
        "middle_name": "ADEBUKOLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "231077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fate, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.