Funmilola O Odutayo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

730330 Issued in TX

Practice address

3200 Avenue I
Rosenberg, TX 77471-3630

Phone

(832) 344-3650

Fax

(832) 344-3898

NPI assigned

Oct 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: funmilola.odutayo.1@28857.direct.athenahealth.com

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.

• Adeline Memorial Medical Group PLLC

  • Family Nurse Practitioner
  • Rosenberg, TX
  • NPI 1760075667
  Medicare reassignment Authorized official
• Izuchukwu Okpara MD, P.a.

  • Surgery Physician
  • Houston, TX
  • NPI 1306531629
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863
  Medicare reassignment NPD
• Vpa of Texas PLLC

  • Family Medicine Physician
  • Irving, TX
  • NPI 1679510499
  Medicare reassignment NPD
• Xcess Care Plus Inc.

  • Family Nurse Practitioner
  • Rosenberg, TX
  • NPI 1891329835
  NPD Authorized official
• Vpa of Texas PLLC

  • Clinical Social Worker
  • San Antonio, TX
  • NPI 1578175865
  NPD
• Vpa of Texas PLLC

  • Family Medicine Physician
  • Irving, TX
  • NPI 1942829155
  NPD

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1679761845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 AVENUE I",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774713630",
            "telephone_number": "832-344-3650",
            "fax_number": "832-344-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 AVENUE I",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774713630",
            "telephone_number": "832-344-3650",
            "fax_number": "832-344-3898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6776 Southwest Fwy Ste 5306776",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770742107",
            "country_code": "US",
            "telephone_number": "832-400-2354",
            "fax_number": "832-400-2355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODUTAYO",
        "first_name": "FUNMILOLA",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-12",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "730330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances Nwora
• Blessing Nwosa
• Agatha Uche Nwosu
• Prisca Nwosu
• Betty Obaseki
• Chiagoziem O Ogbonnaya
• Olubunmi Ogunade-Lawal
• Faris G. Ohan, O. D.
• Blessing Chinecherem Okafor, PMHNP (NP)
• Joshua Glen Okain, BCBA, LBA

• Family Nurse Practitioner in Rosenberg, TX
• Providers in Rosenberg, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.