NPIMap

Individual provider Active NPI

John Oluwaseyi Odumosu

  • Anesthesiology Physician
  • Chapel Hill, NC
National Provider Identifier
1407437361
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2022-02629 Issued in NC
Practice address
101 Manning Dr # 7600
Chapel Hill, NC 27514-4220
Phone
(919) 966-5136
NPI assigned
Apr 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101282325 VA
Student in an Organized Health Care Education/Training Program 390200000X RTL21-0275 NC
Anesthesiology Physician 207L00000X 2022-02629 NC Primary

Addresses

Primary practice location

101 Manning Dr # 7600
Chapel Hill, NC 27514-4220

Mailing address

716 Sleepy Creek Dr
Durham, NC 27713-9132
Phone (252) 327-9662

Other practice location 1

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (252) 327-9662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250822002398 VA Practitioner - Anesthesiology 7214346881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Brody School of Medicine at East Carolina University, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

1613 Oakwood St
Bedford, VA 24523-1213

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022-02629NCMDAnesthesiology Physician
0101282325VAMDAnesthesiology Physician
RTL21-0275NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

101 Manning Dr
#7600
Chapel Hill, NC 27514
Phone (984) 974-0150

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

Interoperability endpoints

  • Direct secure messaging: jodumosu672721@direct.unc.nchie.net

Organizations & group practices 1

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.

Hospital & facility affiliations 8

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": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1407437361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 SLEEPY CREEK DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277139132",
            "telephone_number": "252-327-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR # 7600",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "919-966-5136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Tate Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245011109",
            "country_code": "US",
            "telephone_number": "252-327-9662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODUMOSU",
        "first_name": "JOHN",
        "middle_name": "OLUWASEYI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101282325",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "RTL21-0275",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2022-02629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.