Individual provider Active NPI

Gbemisola Omolara

  • Registered Nurse
  • Kissimmee, FL
National Provider Identifier
1396418489
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9351255 Issued in FL
Practice address
434 Marlberry Leaf Ave
Kissimmee, FL 34758-3690
Phone
(347) 451-9895
NPI assigned
Jul 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9351255 FL Primary

Addresses

Primary practice location

434 Marlberry Leaf Ave
Kissimmee, FL 34758-3690

Mailing address

434 Marlberry Leaf Ave
Kissimmee, FL 34758-3690
Phone (347) 451-9895

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
RN9351255FLMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1396418489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 MARLBERRY LEAF AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347583690",
            "telephone_number": "347-451-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 MARLBERRY LEAF AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347583690",
            "telephone_number": "347-451-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOLARA",
        "first_name": "GBEMISOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9351255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.