Active NPI
Phanuel Rowlands Omulo
- Counselor
- Denver, CO
National Provider Identifier
1649947136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2130 Stout St
Denver, CO 80205-2827 - Phone
- (303) 312-9978
- NPI assigned
- Aug 24, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | KY | Primary |
Addresses
Primary practice location
2130 Stout St
Denver, CO 80205-2827
Mailing address
2111 Champa St
Denver, CO 80205-2529
Phone (303) 293-2220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790731081 | Medicaid | KY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675728000000",
"number": "1649947136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2111 CHAMPA ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802052529",
"telephone_number": "303-293-2220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2130 STOUT ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802052827",
"telephone_number": "303-312-9978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMULO",
"first_name": "PHANUEL",
"middle_name": "ROWLANDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-24",
"last_updated": "2023-02-07",
"certification_date": "2023-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "KY",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1790731081",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.