Grace Adaobi Omoregie-Edewi

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2022041912 Issued in MA

Practice address

8 Wilder St
Brockton, MA 02301-1529

Phone

(781) 771-8576

NPI assigned

Aug 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1568190957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WILDER ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011529",
            "telephone_number": "781-771-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 WILDER ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011529",
            "telephone_number": "781-771-8576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Wilder St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023011529",
            "country_code": "US",
            "telephone_number": "781-771-8576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMOREGIE-EDEWI",
        "first_name": "GRACE",
        "middle_name": "ADAOBI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2022041912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ndia Olivier
• William L Olson, OD
• Joshua Blake Oman
• Michael Omoregie Omigie
• Daniel Omoayo, LCSW
• Joseph Omwata
• Adeyemi O Onayemi, RPH
• Ann Cathrine Ong, DMD
• Luei Wern Ong, M.D.
• Esther Onochie, MSN

• Psychiatric/Mental Health Nurse Practitioner in Brockton, MA
• Providers in Brockton, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.