Individual provider Active NPI

Sherifat Omobola Raimi

  • Registered Nurse
  • Oklahoma City, OK
National Provider Identifier
1629685078
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
127480 Issued in OK
Practice address
8809 NW 84TH St
Oklahoma City, OK 73132-4058
Phone
(405) 248-5891
NPI assigned
Sep 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 127480 OK Primary

Addresses

Primary practice location

8809 NW 84TH St
Oklahoma City, OK 73132-4058

Mailing address

8809 NW 84TH St
Oklahoma City, OK 73132-4058
Phone (405) 248-5890

Other identifiers 1

IdentifierTypeStateIssuer
R082294011MedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
127480OKMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1629685078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8809 NW 84TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731324058",
            "telephone_number": "405-248-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8809 NW 84TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731324058",
            "telephone_number": "405-248-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIMI",
        "first_name": "SHERIFAT",
        "middle_name": "OMOBOLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "127480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R082294011",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.