Johnson Olurotimi Olusanya, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP126233 Issued in TX

Practice address

16350 Angel Island LN
Houston, TX 77053-4336

Phone

(713) 553-3560

NPI assigned

Sep 11, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1861893687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16350 ANGEL ISLAND LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770534336",
            "telephone_number": "713-553-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16350 ANGEL ISLAND LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770534336",
            "telephone_number": "713-553-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUSANYA",
        "first_name": "JOHNSON",
        "middle_name": "OLUROTIMI",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP126233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Marie Olumoko, RN,BC
• Mercy C Olumuyiwa
• Fidel Oluoch
• Oyeboade Olurin
• David Olurinde
• Olubukola Abake Olusanya
• Olusegun B. Awotesu
• Babajide Olatokunbo Olutimehin, M.D.
• Omobolaji Olutimehin, MD
• Olayiwola Oluwaseun Olutola, MD

• Family Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.