Individual provider Active NPI

Omolara Omodele Fadairo, LPN

  • Licensed Practical Nurse
  • Grand Forks, ND
National Provider Identifier
1942112446
Registry record updated Sep 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
L18266 Issued in ND
Practice address
508 S 4TH St
Grand Forks, ND 58201-4712
Phone
(701) 215-5603
NPI assigned
Sep 19, 2026
Last updated
Sep 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L18266 ND Primary

Addresses

Primary practice location

508 S 4TH St
Grand Forks, ND 58201-4712

Mailing address

508 S 4TH St
Grand Forks, ND 58201-4712
Phone (701) 215-5603

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": "1789776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789776000000",
    "number": "1942112446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S 4TH ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014712",
            "telephone_number": "701-215-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S 4TH ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014712",
            "telephone_number": "701-215-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADAIRO",
        "first_name": "OMOLARA",
        "middle_name": "OMODELE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-19",
        "last_updated": "2026-09-19",
        "certification_date": "2026-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "ND",
            "license": "L18266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.