Omotayo Kehinde Onanubosi, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2019011415 Issued in ID

Practice address

12324 S Abbott Downing Way
Nampa, ID 83686-5693

Phone

(208) 283-7062

NPI assigned

Apr 23, 2021

Last updated

Apr 23, 2021By the provider in NPPES

Sex

Female

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

• Omotayo Kehinde Akinremi Former name

Medicare fee-for-service enrollment

Enrolled in ID

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  ID, Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1750963377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12324 S ABBOTT DOWNING WAY",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865693",
            "telephone_number": "208-283-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12324 S ABBOTT DOWNING WAY",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865693",
            "telephone_number": "208-283-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONANUBOSI",
        "first_name": "OMOTAYO",
        "middle_name": "KEHINDE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "2019011415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OMOTAYO",
            "last_name": "AKINREMI",
            "middle_name": "KEHINDE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David R Olson, MA
• Jacquilyn Olson
• Megan Jo Olson, LMSW
• Preston S Omer, M.D.
• Lisa Omori, L.P.C.
• Onsite Dental, PLLC
• Matthew Scott Orme
• Bonna R Ormond, DNP, FNP-BC
• Taylor Ormsby
• Julia Ostyn, PHARMD

• Nurse Practitioner in Nampa, ID
• Providers in Nampa, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.