Individual provider Active NPI

Oluwakemi Olagundoye, FNP

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1780165712
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP10429 Issued in TX
Practice address
9050 Cook Rd
Houston, TX 77099-1463
Phone
(713) 774-9300
Fax
(713) 774-9301
NPI assigned
Aug 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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 AP10429 TX Primary
Registered Nurse 163W00000X 843958 TX

Addresses

Primary practice location

9050 Cook Rd
Houston, TX 77099-1463

Mailing address

15702 Brookwood Lake PL
Sugar Land, TX 77498-7145
Phone (832) 318-3987

Other practice location 1

4502 Riverstone Blvd Ste 905
Missouri City, TX 77459-5206
Phone (281) 903-7613

Other identifiers 1

IdentifierTypeStateIssuer
1952618993MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
843958TXMDRegistered Nurse
AP10429TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nestar Med Care LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1780165712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15702 BROOKWOOD LAKE PL",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774987145",
            "telephone_number": "832-318-3987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 COOK RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770991463",
            "telephone_number": "713-774-9300",
            "fax_number": "713-774-9301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4502 Riverstone Blvd Ste 905",
            "address_purpose": "LOCATION",
            "city": "Missouri City",
            "state": "TX",
            "postal_code": "774595206",
            "country_code": "US",
            "telephone_number": "281-903-7613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLAGUNDOYE",
        "first_name": "OLUWAKEMI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP10429",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "843958",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952618993",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.