Individual provider Active NPI

Rosemourine Chinwendu Obi, CRNP

  • Adult Health Nurse Practitioner
  • Washington, DC
National Provider Identifier
1659985943
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R235552 Issued in MD
Practice address
1160 Varnum St NE Ste 218
Washington, DC 20017-2106
Phone
(202) 269-6600
NPI assigned
Sep 3, 2020
Last updated
Jun 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN1039612 DC
Adult Health Nurse Practitioner 363LA2200X R235552 MD Primary
Gerontology Registered Nurse 163WG0600X RN1039612 DC
Medical-Surgical Registered Nurse 163WM0705X R235552 MD
Medical-Surgical Registered Nurse 163WM0705X RN1039612 DC

Addresses

Primary practice location

1160 Varnum St NE Ste 218
Washington, DC 20017-2106

Mailing address

1160 Varnum Street NE. Suite #218, Washington, District
Washington DC, DC 20017-2324
Phone (202) 269-6600

Other identifiers 1

IdentifierTypeStateIssuer
1659985943OtherMDMARYLAND BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, VA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20231130000329 DC Practitioner - Nurse Practitioner 9133513005 Reassigns benefits to 1 organization
I20250828002265 MD Practitioner - Nurse Practitioner 9133513005
I20260624000356 VA Practitioner - Nurse Practitioner 9133513005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12900 Park Plaza Dr
Suite 150
Cerritos, CA 90703-9329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN1039612DCMDGerontology Registered Nurse
R235552MDMDMedical-Surgical Registered Nurse

Interoperability endpoints

  • Direct secure messaging: robi34930@carelonhealth.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1659985943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 VARNUM STREET NE. SUITE #218, WASHINGTON, DISTRICT",
            "city": "WASHINGTON DC",
            "state": "DC",
            "postal_code": "200172324",
            "telephone_number": "202-269-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 VARNUM ST NE STE 218",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172106",
            "telephone_number": "202-269-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBI",
        "first_name": "ROSEMOURINE",
        "middle_name": "CHINWENDU",
        "name_prefix": "Miss",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "DC",
            "license": "RN1039612",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R235552",
            "primary": true
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "DC",
            "license": "RN1039612",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MD",
            "license": "R235552",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "DC",
            "license": "RN1039612",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BOARD OF NURSING",
            "identifier": "1659985943",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.