Kikelomo Omotoso

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

8360 Issued in AZ

Practice address

2500 Canyon Rd
Ste A1
Bullhead City, AZ 86442

Phone

(928) 704-4499

Fax

(928) 704-4949

NPI assigned

Mar 9, 2016

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 NV

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nader Y. Abdelsayed, M.D., Professional CorporationGroup PAC ID 1557514692, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Nader Y. Abdelsayed, M.D., Professional Corporation

  • Obstetrics & Gynecology Physician
  • North Las Vegas, NV
  • NPI 1841536901
  Medicare reassignment Care Compare group NPD
• Dignity Health

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1770626426
  NPD (past)

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1700247418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 CANYON RD",
            "address_2": "STE A1",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-704-4499",
            "fax_number": "928-704-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 CANYON RD",
            "address_2": "STE A1",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-704-4499",
            "fax_number": "928-704-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOTOSO",
        "first_name": "KIKELOMO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-09",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "AZ",
            "license": "8360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• OB-GYN Women'S Center, PC
• Adenike Okoduwa, PHARMD
• Elijah Don Oliverson, DDS
• James Olson, RPH
• Janalea S Olson, RPH
• Christal Bustos-Camama Orris, DNAP CRNA
• Ryan Orton, DPT
• Patrick Joseph Osmonson, LISAC, CCTP
• Sook Yun Owen
• Chol Pae

• Obstetrics & Gynecology Nurse Practitioner in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Obstetrics & Gynecology Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.