Active NPI
Jasper Evans Omolo
- Registered Nurse
- Huber Heights, OH
National Provider Identifier
1417229964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN.373941
- Practice address
- 7015 Bascombe Dr
Huber Heights, OH 45424-2905 - Phone
- (937) 344-4451
- NPI assigned
- Jan 30, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN.373941 | OH | Primary |
Addresses
Primary practice location
7015 Bascombe Dr
Huber Heights, OH 45424-2905
Mailing address
7015 Bascombe Dr
Huber Heights, OH 45424-2905
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN.373941 | OH | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327881600000",
"number": "1417229964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7015 BASCOMBE DR",
"city": "HUBER HEIGHTS",
"state": "OH",
"postal_code": "454242905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7015 BASCOMBE DR",
"city": "HUBER HEIGHTS",
"state": "OH",
"postal_code": "454242905",
"telephone_number": "937-344-4451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMOLO",
"first_name": "JASPER",
"middle_name": "EVANS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-30",
"last_updated": "2012-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN.373941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huber Heights, OH
- Occupational Health Centers of Ohio, PA, Co (Concentra Medical Center)
- Linda Ebelechukwu Odenigbo, MD
- Ohio CVS Stores LLC (CVS Pharmacy #03080)
- Ohio CVS Stores LLC (CVS Pharmacy #)
- Ohio Home Health Care, Inc.
- Angela D Ondreck
- One Queen 6 Roses
- Optical Fashion Centers Inc
- Casie M. Oroszi, BT
- Tamara L Ortega
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.