Daud Biola Koleosho

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

253415 Issued in AZ

Practice address

1840 E Baseline Rd Ste A1
Tempe, AZ 85283-1527

Phone

(480) 718-5400

Fax

(877) 666-4624

NPI assigned

Feb 3, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clear Stone Health Services

  • Substance Abuse Rehabilitation Facility
  • Glendale, AZ
  • NPI 1871366658
  NPD Authorized official
• Grande Integrated Wellness Solutions LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1992577555
  NPD

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1962093781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421806",
            "telephone_number": "480-718-5400",
            "fax_number": "877-666-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 E BASELINE RD STE A1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831527",
            "telephone_number": "480-718-5400",
            "fax_number": "877-666-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLEOSHO",
        "first_name": "DAUD",
        "middle_name": "BIOLA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "253415",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "253415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Gilbert",
            "affiliation": "N",
            "address_1": "3507 E Mesquite St",
            "city": "Gilbert",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852961829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Keith Alan Kocher, PT, MOMT
• Bjorn Andrew Koester, DPT
• Lynn Koester, PHARMD
• David Allen Kohl, M.S.W., L.C.S.W.
• Karlyn Marie Kohler, NP
• Cheryl Kollin, N.M.D
• Margaret Komar, RNP
• Konkle & Tanner Dental Care, LLC
• Konkle & Tanner Dental Care, LLC
• Jennifer H. Konkle, D.D.S.

• Primary Care Nurse Practitioner in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.