Individual provider Active NPI

Omololu Majekodunmi, OTR/L

  • Occupational Therapist
  • Washington, DC
National Provider Identifier
1629480710
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
07155 Issued in MD
Practice address
4900 Massachusetts Ave NW Ste 340
Washington, DC 20016-4358
Phone
(202) 794-6820
NPI assigned
May 23, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Student in an Organized Health Care Education/Training Program 390200000X
Occupational Therapist 225X00000X 07155 MD Primary
Speech-Language Pathologist 235Z00000X
Nutrition Education Nutritionist 133NN1002X
Health Educator 174H00000X
Clinical Exercise Physiologist 224Y00000X
Occupational Therapist 225X00000X 010000891 DC

Addresses

Primary practice location

4900 Massachusetts Ave NW Ste 340
Washington, DC 20016-4358

Mailing address

1710 W Virginia Ave NE Unit 101
Washington, DC 20002-2338
Phone (202) 739-1861

Other practice location 1

1710 W Virginia Ave NE Unit 101
Washington, DC 20002-2338
Phone (202) 739-1861

Other practice location 2

1331 H St NW Ste 200
Washington, DC 20005-4706
Phone (202) 794-6820

Other practice location 3

8320 Old Courthouse Rd Ste 401
Vienna, VA 22182-3848
Phone (202) 794-6820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200910000504 DC Practitioner - Occupational Therapist in Private Practice 7214355189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010000891DCMDOccupational Therapist
07155MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Triumph Pediatrics LLC Speech-Language Pathologist Current Accepting new patients
Triumph Pediatric Center Speech-Language Pathologist CurrentSince Jun 28, 2020 Accepting new patients
Triumph Therapeutics LLC Nutritionist CurrentSince May 31, 2020 Accepting new patients

Locations

1331 H St NW
Ste 200
Washington, DC 20005
Phone (202) 417-6576

4900 Massachusetts Ave NW
Ste 305
Washington, DC 20016
Phone (202) 739-1861

4900 Massachusetts Ave NW
Ste 340
Washington, DC 20016
Phone (202) 621-9793

8320 Old Courthouse Rd
Ste 401
Vienna, VA 22182
Phone (571) 999-7973

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": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1629480710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 W VIRGINIA AVE NE UNIT 101",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200022338",
            "telephone_number": "202-739-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MASSACHUSETTS AVE NW STE 340",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200164358",
            "telephone_number": "202-794-6820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1710 W Virginia Ave NE Unit 101",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200022338",
            "country_code": "US",
            "telephone_number": "202-739-1861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1331 H St NW Ste 200",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200054706",
            "country_code": "US",
            "telephone_number": "202-794-6820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8320 Old Courthouse Rd Ste 401",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221823848",
            "country_code": "US",
            "telephone_number": "202-794-6820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAJEKODUNMI",
        "first_name": "OMOLOLU",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-23",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "07155",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "DC",
            "license": "010000891",
            "primary": false
        }
    ],
    "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 Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.