NPIMap

Individual provider Active NPI

Oluwademilade O Evbuomwan-Buraimoh, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1730688151
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP136361 Issued in TX
Practice address
3614 Camp Bowie Blvd
Fort Worth, TX 76107-3352
Phone
(817) 870-1873
NPI assigned
Feb 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28177 SC
Family Nurse Practitioner 363LF0000X AP136361 TX Primary

Addresses

Primary practice location

3614 Camp Bowie Blvd
Fort Worth, TX 76107-3352

Mailing address

3614 Camp Bowie Blvd
Fort Worth, TX 76107-3352
Phone (817) 870-1873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180608000506 TX Practitioner - Nurse Practitioner 4082969373 Reassigns benefits to 3 organizations
I20240604004495 SC Practitioner - Nurse Practitioner 4082969373 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians
Minuteclinic Diagnostic of Texas PLLCGroup PAC ID 7416039177, 253 clinicians

Practice addresses (Care Compare)

1 Saint Francis Dr
Greenville, SC 29601-3955
Phone (864) 255-1000

3614 Camp Bowie Blvd
Fort Worth, TX 76107-3352
Phone (866) 389-2727

Hospital & facility affiliations

  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP136361TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalen Inpatient Care, PC CurrentSince May 1, 2024 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jul 9, 2024 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jul 9, 2024 Accepting new patients
Vitalen Inpatient Care PC CurrentSince May 1, 2024 Accepting new patients
Diagnostic Pro Imaging Past Accepting new patients

Locations

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

125 Commonwealth Dr
Greenville, SC 29615
Phone (864) 225-1800

Organizations & group practices 8

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1730688151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3614 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073352",
            "telephone_number": "817-870-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073352",
            "telephone_number": "817-870-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVBUOMWAN-BURAIMOH",
        "first_name": "OLUWADEMILADE",
        "middle_name": "O",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "28177",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.