Individual provider Active NPI

Olaronke Vickie Oshokpekhai

  • Adult Health Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1407505969
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0028512 Issued in OH
Practice address
1330 N Lee Trevino Dr
El Paso, TX 79936-6417
Phone
(513) 290-2119
NPI assigned
Mar 22, 2022
Last updated
Mar 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0028512 OH Primary

Addresses

Primary practice location

1330 N Lee Trevino Dr
El Paso, TX 79936-6417

Mailing address

5086 Luna CT
Liberty Township, OH 45044-7578
Phone (151) 329-0211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241021003222 OH Practitioner - Nurse Practitioner 8022540608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illumia Health LLCGroup PAC ID 7810424306, 33 clinicians

Practice addresses (Care Compare)

Dayton, OH 45459
Phone (937) 910-4004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0028512OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Illumia Health LLC CurrentSince Nov 11, 2024 Accepting new patients
Illumia Health LLC CurrentSince Nov 11, 2024 Accepting new patients

Locations

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

4040 Embassy Pkwy
Ste 410
Akron, OH 44333
Phone (330) 576-5405

7887 Washington Village Dr
Ste 265
Dayton, OH 45459

Organizations & group practices 2

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": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1407505969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5086 LUNA CT",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450447578",
            "telephone_number": "151-329-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 N LEE TREVINO DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366417",
            "telephone_number": "513-290-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSHOKPEKHAI",
        "first_name": "OLARONKE",
        "middle_name": "VICKIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "0028512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.