Individual provider Active NPI

Omowunmi Jolaoso, ATC, CSCS

  • Athletic Trainer
  • Frostburg, MD
National Provider Identifier
1457819872
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
A0001134 Issued in MD
Practice address
84 Bowery St Apt 1
Frostburg, MD 21532-1832
Phone
(267) 475-8034
NPI assigned
Mar 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193400000X SINGLE SPECIALTY GROUP 2255A2300X A0001134 MD Primary

Addresses

Primary practice location

84 Bowery St Apt 1
Frostburg, MD 21532-1832

Mailing address

84 Bowery St Apt 1
Frostburg, MD 21532-1832
Phone (267) 475-8034

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
A0001134MDMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1457819872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 BOWERY ST APT 1",
            "city": "FROSTBURG",
            "state": "MD",
            "postal_code": "215321832",
            "telephone_number": "267-475-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 BOWERY ST APT 1",
            "city": "FROSTBURG",
            "state": "MD",
            "postal_code": "215321832",
            "telephone_number": "267-475-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLAOSO",
        "first_name": "OMOWUNMI",
        "credential": "ATC, CSCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0001134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frostburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.