Individual provider Active NPI

Michael Othuke Okpolokpo, RN

  • Registered Nurse
  • Washington, DC
National Provider Identifier
1508446931
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
807340 Issued in NY
Practice address
6120 Kansas Ave NE
Washington, DC 20011-1531
Phone
(443) 983-8465
NPI assigned
Apr 9, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 807340 NY Primary

Addresses

Primary practice location

6120 Kansas Ave NE
Washington, DC 20011-1531

Mailing address

1410 Barnacle Geese CT
Upper Marlboro, MD 20774-7102
Phone (443) 983-8465

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
807340NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1508446931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 BARNACLE GEESE CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207747102",
            "telephone_number": "443-983-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 KANSAS AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200111531",
            "telephone_number": "443-983-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKPOLOKPO",
        "first_name": "MICHAEL",
        "middle_name": "OTHUKE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "807340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.