Toyin Kikelomo Omotosho, RN

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Practice address

2908 Montalbo
Grand Prairie, TX 75054-6506

Phone

(972) 352-9449

NPI assigned

Oct 12, 2018

Last updated

Mar 13, 2019By 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 identifiers 1

Other names 1

• Mrs. Toyin Kikelomo Omotosho Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1760957070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 MONTALBO",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750546506",
            "telephone_number": "972-352-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 MONTALBO",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750546506",
            "telephone_number": "972-352-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOTOSHO",
        "first_name": "TOYIN",
        "middle_name": "KIKELOMO",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-12",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23316098",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOYIN",
            "last_name": "OMOTOSHO",
            "middle_name": "KIKELOMO",
            "prefix": "MRS.",
            "credential": "TOYIN OMOTOSHO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Developmental Disabilities Clinic/Center in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Developmental Disabilities Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.