Theresa Omohundro, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

727901 Issued in TX

Practice address

5005 N Piedras St
William Beaumont Army Medical Center
El Paso, TX 79920-5001

Phone

(915) 569-2723

NPI assigned

Feb 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1871762344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 N PIEDRAS ST",
            "address_2": "WILLIAM BEAUMONT ARMY MEDICAL CENTER",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799205001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 N PIEDRAS ST",
            "address_2": "WILLIAM BEAUMONT ARMY MEDICAL CENTER",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799205001",
            "telephone_number": "915-569-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOHUNDRO",
        "first_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP125358",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "727901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omni Hospice of El Paso Inc
• Omni Hospice of El Paso Inc
• Omnicare TX Holdco LLC
• Omnicare TX LLC
• Isabel Omoegbele, PHARMD
• Mobolaji Johnson Omotosho, DPT
• On Time Medical Transit LLC
• On-Site Crisis Intervention LLC
• Eduardo Javier Onate, M.D.
• Oncology Pharmacy Services , Inc. (Texas Oncology Pharmacy - El Paso Grandview)

• Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.