Individual provider Active NPI

Olubunmi Awe, NP

  • Family Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1558739730
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP128858 Issued in TX
Practice address
830 Mayfield Rd
Ste 100
Grand Prairie, TX 75052-3728
Phone
(214) 400-2000
NPI assigned
Sep 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP128858 TX Primary

Addresses

Primary practice location

830 Mayfield Rd
Ste 100
Grand Prairie, TX 75052-3728

Mailing address

5160 Finnhorse Dr
Grand Prairie, TX 75052-2562
Phone (214) 400-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160112000569 TX Practitioner - Nurse Practitioner 3375788607 Practice locations: Grand Prairie, TX

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

830 Mayfield Rd
Suite 100
Grand Prairie, TX 75052-3728
Phone (469) 999-0009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP128858TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peace Health and Wellness Clinic CurrentSince Sep 20, 2020 Accepting new patients
Tai Ventures Past Accepting new patients
Tairose Home Health Services Inc Past Accepting new patients

Locations

830 Mayfield Rd
Ste 100
Grand Prairie, TX 75052
Phone (214) 400-2000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1558739730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5160 FINNHORSE DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522562",
            "telephone_number": "214-400-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 MAYFIELD RD",
            "address_2": "STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523728",
            "telephone_number": "214-400-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWE",
        "first_name": "OLUBUNMI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-04",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP128858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.