Individual provider Active NPI

Omowunmi Folasade Aiyeola

  • Licensed Vocational Nurse
  • Grand Prairie, TX
National Provider Identifier
1922508878
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
340593 Issued in TX
Practice address
2625 Stonelake Dr
Grand Prairie, TX 75050-8790
Phone
(347) 677-4614
NPI assigned
Feb 16, 2018
Last updated
Feb 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 340593 TX Primary

Addresses

Primary practice location

2625 Stonelake Dr
Grand Prairie, TX 75050-8790

Mailing address

2625 Stonelake Dr Apt 522
Grand Prairie, TX 75050-8789
Phone (347) 677-4614

Other names 1

  • Omowunmi Aiyeola Other name

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

State licenses

LicenseStateTypeSpecialty
340593TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1922508878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 STONELAKE DR APT 522",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750508789",
            "telephone_number": "347-677-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 STONELAKE DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750508790",
            "telephone_number": "347-677-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIYEOLA",
        "first_name": "OMOWUNMI",
        "middle_name": "FOLASADE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "340593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OMOWUNMI",
            "last_name": "AIYEOLA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.