Wenesh M. Oboso, CEO

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

R097782 Issued in AR

Practice address

3301 Ridgway Rd Apt B6
Pine Bluff, AR 71603-7434

Phone

(870) 592-0803

Fax

(870) 879-9660

NPI assigned

May 2, 2019

Last updated

May 2, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Wenesh M Oboso Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

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  Authorized official Same address or phone

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1750946984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 RIDGWAY RD APT B6",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037434",
            "telephone_number": "870-592-0803",
            "fax_number": "870-879-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 RIDGWAY RD APT B6",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037434",
            "telephone_number": "870-592-0803",
            "fax_number": "870-879-9660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 Ridgway Rd Apt B6",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716037434",
            "country_code": "US",
            "telephone_number": "870-592-0803",
            "fax_number": "870-879-9660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3301 Ridgway Rd Apt B6",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716037434",
            "country_code": "US",
            "telephone_number": "870-592-0803",
            "fax_number": "870-879-9660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBOSO",
        "first_name": "WENESH",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "CEO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-02",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "AR",
            "license": "R097782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENESH",
            "last_name": "OBOSO",
            "middle_name": "M",
            "credential": "CEO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Marian O Obi, MD
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• Amber Nicole Offutt, APRN
• Michael R Olegario, PT
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• Open Wings in Home Care

• General Practice Registered Nurse in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• General Practice Registered Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.