Active NPI
Dagogo Opusunju
- Family Nurse Practitioner
- Canal Winchester, OH
National Provider Identifier
1720242811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 16450
- Practice address
- 8929 White Oak Dr
Canal Winchester, OH 43110-8028 - Phone
- (614) 920-3668
- NPI assigned
- Jul 17, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | RN 309864 | OH | |
| Family Nurse Practitioner | 363LF0000X | 16450 | OH | Primary |
Addresses
Primary practice location
8929 White Oak Dr
Canal Winchester, OH 43110-8028
Mailing address
8929 White Oak Dr
Canal Winchester, OH 43110-8028
Phone (614) 920-3668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN 309864 | OH | MD | Home Health Registered Nurse |
| 16450 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beta Health Inc. | Current | Accepting new patients |
Organizations & group practices 3
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.
-
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- NPI 1497308456
-
- Home Health Agency
- Columbus, OH
- NPI 1093912347
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409702400000",
"number": "1720242811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8929 WHITE OAK DR",
"city": "CANAL WINCHESTER",
"state": "OH",
"postal_code": "431108028",
"telephone_number": "614-920-3668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8929 WHITE OAK DR",
"city": "CANAL WINCHESTER",
"state": "OH",
"postal_code": "431108028",
"telephone_number": "614-920-3668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPUSUNJU",
"first_name": "DAGOGO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-17",
"last_updated": "2014-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "OH",
"license": "RN 309864",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "16450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canal Winchester, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.