Individual provider Active NPI

Ediomi Enebong Oduwole, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1356996326
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8117 Issued in MN
Practice address
24 Greenway PLZ Ste 1800
Houston, TX 77046-2457
Phone
(507) 353-2419
Fax
(507) 607-8967
NPI assigned
Aug 7, 2019
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP142164 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8117 MN Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 82079 KS

Addresses

Primary practice location

24 Greenway PLZ Ste 1800
Houston, TX 77046-2457

Mailing address

24 Greenway PLZ Ste 1800
Houston, TX 77046-2457
Phone (507) 353-2419

Other practice location 1

6611 E Central Ave Ste C
Wichita, KS 67206-1937
Phone (507) 353-2419

Other practice location 2

7201 Metro Blvd Ste 550
Edina, MN 55439-1353
Phone (507) 353-2419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MN, KS3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20191014000739 TX Practitioner - Nurse Practitioner 5496086001 Reassigns benefits to 1 organization
I20211209002599 MN Practitioner - Nurse Practitioner 5496086001 Reassigns benefits to 3 organizations
I20230516001126 KS Practitioner - Nurse Practitioner 5496086001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4925 S Broadway Ave
Suite 1077
Wichita, KS 67216-3716
Phone (507) 353-2419

5123 W 98TH St
Suite 2023
Minneapolis, MN 55437-2040
Phone (832) 206-1265

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8117MNMDPhysical Therapist
82079KSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Feb 16, 2024 Accepting new patients
Pleasant Place Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jun 26, 2023 Accepting new patients
Grow Healthcare Group of Kansas PA Psychiatric/Mental Health CurrentSince Mar 5, 2024 Accepting new patients
Western Mental Health Center, Inc. CurrentSince Sep 1, 2021 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

4925 S Broadway Ave
Wichita, KS 67216
Phone (316) 227-1989

6611 E Central Ave
Ste C
Wichita, KS 67206
Phone (316) 650-1877

801 E Douglas Ave
Fl 2ND
Wichita, KS 67202
Phone (316) 974-3161

1212 E College Dr
Marshall, MN 56258
Phone (507) 532-3236

5123 W 98th St
Minneapolis, MN 55437
Phone (312) 961-4490

7201 Metro Blvd
Ste 550
Minneapolis, MN 55439
Phone (612) 208-6807

2355 Highway 36 W
Ste 400
Saint Paul, MN 55113
Phone (612) 460-1597

1415 North Loop W
Ste 30014
Houston, TX 77008
Phone (321) 413-1411

24 Greenway Plz
Ste 1800
Houston, TX 77046
Phone (281) 262-2230

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/wmhcinc/r4/

Organizations & group practices 4

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": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1356996326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 GREENWAY PLZ STE 1800",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770462457",
            "telephone_number": "507-353-2419",
            "fax_number": "507-607-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 GREENWAY PLZ STE 1800",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770462457",
            "telephone_number": "507-353-2419",
            "fax_number": "507-607-8967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6611 E Central Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672061937",
            "country_code": "US",
            "telephone_number": "507-353-2419",
            "fax_number": "507-607-8967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7201 Metro Blvd Ste 550",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554391353",
            "country_code": "US",
            "telephone_number": "507-353-2419",
            "fax_number": "507-607-8967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODUWOLE",
        "first_name": "EDIOMI",
        "middle_name": "ENEBONG",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP142164",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8117",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "82079",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.