Active NPI
Roseline Omolola Popoola, BS
- Nurse's Aide
- Florissant, MO
National Provider Identifier
1457965352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 123336
- Practice address
- 652 Foxtail Dr
Florissant, MO 63034-2035 - Phone
- (314) 583-2694
- NPI assigned
- Sep 8, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 123336 | MO | Primary |
Addresses
Primary practice location
652 Foxtail Dr
Florissant, MO 63034-2035
Mailing address
652 Foxtail Dr
Florissant, MO 63034-2035
Phone (314) 583-2694
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123336 | MO | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1457965352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "652 FOXTAIL DR",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630342035",
"telephone_number": "314-583-2694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "652 FOXTAIL DR",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630342035",
"telephone_number": "314-583-2694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPOOLA",
"first_name": "ROSELINE",
"middle_name": "OMOLOLA",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-08",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "MO",
"license": "123336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florissant, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.