Individual provider Active NPI

Rodgers Otieno

  • Clinical Social Worker
  • Ewa Beach, HI
National Provider Identifier
1861325755
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
119024 Issued in TX
Practice address
91-2114 Kanela St
Ewa Beach, HI 96706-5962
Phone
(405) 628-7635
NPI assigned
Jun 8, 2026
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 119024 TX Primary

Addresses

Primary practice location

91-2114 Kanela St
Ewa Beach, HI 96706-5962

Mailing address

91-2114 Kanela St
Ewa Beach, HI 96706-5962

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1780876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1861325755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-2114 KANELA ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967065962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-2114 KANELA ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967065962",
            "telephone_number": "405-628-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIENO",
        "first_name": "RODGERS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-08",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "119024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.