Omobonike Olowosuko, D.O

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

334189 Issued in LA

Practice address

2614 Jefferson Hwy
New Orleans, LA 70121-3828

Phone

(504) 291-5100

Fax

(504) 291-5125

NPI assigned

Nov 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, MT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: oolowosuko1677467@direct.ochsner.org
• Direct secure messaging: oolowosuko840632@ahs.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• RCHP Billings - Missoula LLC

  • Specialist
  • Missoula, MT
  • NPI 1376946913
  Medicare reassignment NPD
• Ut Regional One Physicians Inc

  • Surgery Physician
  • Memphis, TN
  • NPI 1093130585
  Medicare reassignment NPD
• Meritus Medical Center Inc

  • Nurse Practitioner
  • Hagerstown, MD
  • NPI 1205176393
  NPD
• Meritus Medical Center Inc

  • Anesthesiology Physician
  • Hagerstown, MD
  • NPI 1255199246
  NPD
• RCHP Billings - Missoula LLC

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1891164125
  NPD
• Ut Regional One Physicians Inc

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1285042028
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1386911766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701213828",
            "telephone_number": "504-291-5100",
            "fax_number": "504-291-5125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "888 Old Country Rd",
            "address_purpose": "LOCATION",
            "city": "Plainview",
            "state": "NY",
            "postal_code": "118034914",
            "country_code": "US",
            "telephone_number": "516-719-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 SW 7th St",
            "address_purpose": "LOCATION",
            "city": "Topeka",
            "state": "KS",
            "postal_code": "666062489",
            "country_code": "US",
            "telephone_number": "785-295-8571",
            "fax_number": "785-295-5543",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1504 SW 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Topeka",
            "state": "KS",
            "postal_code": "666061632",
            "country_code": "US",
            "telephone_number": "620-481-9155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2827 Fort Missoula Rd",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598047408",
            "country_code": "US",
            "telephone_number": "406-369-5569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLOWOSUKO",
        "first_name": "OMOBONIKE",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-29",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KS",
            "license": "05-46887",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MT",
            "license": "MED-PHYS-COM-LIC-123",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "2968",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "H0083162",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "LA",
            "license": "334189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John J Olivier, MD
• Kristine Urban Olivier, M.D.
• Tonya L Olivier, D.C.
• Daniel James Olix, MD
• Queen Olocha
• Kelsey Nichole Olsen, ATC
• Elizabeth Hodgkinson Olson, M.D. M.P.H.
• Jeanette A Olson, CRNA
• Laurie H Olson, PH.D.
• Payton Olson

• Physical Medicine & Rehabilitation Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Physical Medicine & Rehabilitation Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.