Enehomere I. Okoruwa, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

30593 Issued in IA

Practice address

3135 W Broadway
Council Bluffs, IA 51501-3359

Phone

(712) 328-9100

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

No

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

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eokoruwa37936@achce.catholichealth.net

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.

• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069
  Medicare reassignment NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  NPD
• Alegent Health Bergan Mercy Health System

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1265517759
  NPD (past)
• Jennie Edmundson Memorial Hospital

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1457448755
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1568512564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3135 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013359",
            "telephone_number": "712-328-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3135 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013359",
            "telephone_number": "712-328-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKORUWA",
        "first_name": "ENEHOMERE",
        "middle_name": "I.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "30593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mirabel Nchedo Nwosu
• Tessa O'Neill, APRN
• Emily O'Rourke
• Amy Oberdin
• Jason T Ohr, M.D.
• Danelle K Oliver, LMSW
• Justine Marie Olsen, OTD
• Roseanne M Olsen, MS, LPC, LMHC, LMHP
• Olson Eye Care PLC
• Christopher Robert Olson, OD

• Pediatrics Physician in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.