Anita Aisha Obehi Momodu

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

8615 Isla Vista Valley CT
Las Vegas, NV 89178-7521

Phone

(702) 325-9756

NPI assigned

Jun 24, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Halcyon Services

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1376937375
  NPD (past) Authorized official

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1558776914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8615 ISLA VISTA VALLEY CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891787521",
            "telephone_number": "702-325-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8615 ISLA VISTA VALLEY CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891787521",
            "telephone_number": "702-325-9756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMODU",
        "first_name": "ANITA",
        "middle_name": "AISHA OBEHI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mom and Pop Caregiving Agency Inc
• Moments N Memories Banquet Hall LLC.
• Momentum Counseling Services
• George Dalsuke Momii, M.D.
• Abdul-Rasheed Momodu
• Obiageli Momodu
• Pouya Momtaz, DMD, MS
• Momway LLC
• Mon-Han Young, D.M.D., PC
• Nicolle Alexandra Mona

• Rehabilitation Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Rehabilitation Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.