Individual provider Active NPI

Oyenmwen Edo-Ohonba, MD

  • Family Medicine Physician
  • Columbia, MO
National Provider Identifier
1649731498
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019020874 Issued in MO
Practice address
1 Hospital Dr
Columbia, MO 65212-1000
Phone
(573) 884-7060
NPI assigned
Mar 26, 2019
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 01087892A IN
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 2019020874 MO Primary

Addresses

Primary practice location

1 Hospital Dr
Columbia, MO 65212-1000

Mailing address

1001 W Worley St
Columbia, MO 65203-2037
Phone (573) 214-2314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220908002572 IN Practitioner - Hospitalist 7719213834 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians

Practice addresses (Care Compare)

600 Mary St
Evansville, IN 47710-1658
Phone (812) 450-7299

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01087892AINMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Physicians of Indiana, PC Family Medicine CurrentSince Dec 1, 2022 Accepting new patients
Deaconess Hospital, Inc Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Deaconess Clinic, Inc. CurrentSince Dec 1, 2022 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic Inc Family Medicine CurrentSince Dec 1, 2022 Accepting new patients
Deaconess Hospital Inc CurrentSince Jul 1, 2022 Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

545 S Boehne Camp Rd
Evansville, IN 47712
Phone (812) 402-1264

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

4011 Gateway Blvd
Ste 100
Newburgh, IN 47630
Phone (812) 858-2100

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1649731498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W WORLEY ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032037",
            "telephone_number": "573-214-2314",
            "fax_number": "573-814-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652121000",
            "telephone_number": "573-884-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDO-OHONBA",
        "first_name": "OYENMWEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01087892A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2019020874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.