Individual provider Active NPI

Oluchi Silverline Obiesie, AGACNP

  • Acute Care Nurse Practitioner
  • Aventura, FL
National Provider Identifier
1407507916
Registry record updated Jan 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
11011540 Issued in FL
Practice address
21110 Biscayne Blvd Ste 406
Aventura, FL 33180-1252
Phone
(786) 373-8811
NPI assigned
Jan 16, 2022
Last updated
Jan 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11011540 FL Primary

Addresses

Primary practice location

21110 Biscayne Blvd Ste 406
Aventura, FL 33180-1252

Mailing address

2530 NW 131St St
Miami, FL 33167-1343
Phone (786) 353-6119

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
11011540FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Mane LLC CurrentSince Jan 26, 2022 Accepting new patients

Locations

21110 Biscayne Blvd
Ste 406
Miami, FL 33180
Phone (305) 727-4247

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, 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": "1642291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642291200000",
    "number": "1407507916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 NW 131ST ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331671343",
            "telephone_number": "786-353-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21110 BISCAYNE BLVD STE 406",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801252",
            "telephone_number": "786-373-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBIESIE",
        "first_name": "OLUCHI",
        "middle_name": "SILVERLINE",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-16",
        "last_updated": "2022-01-16",
        "certification_date": "2022-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11011540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2022; 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.