Aniebietabasi Okon-Umoren, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4351044811 Issued in MI

Practice address

2799 W Grand Boulevard
Detroit, MI 48202

Phone

(313) 916-1601

Fax

(313) 916-2018

NPI assigned

Jul 3, 2019

Reactivated

Mar 9, 2020

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: aokonumoren572399@direct.hfhs.org

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1992367478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE FORD PLACE 2E",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-874-5378",
            "fax_number": "313-916-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-1601",
            "fax_number": "313-916-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKON-UMOREN",
        "first_name": "ANIEBIETABASI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "deactivation_date": "2020-02-17",
        "reactivation_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351044811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Okezie Wachuku
• Oghenefejiro Okifo, MD
• Isaiah Etuonu Okoh, R.PH.
• Cynthia Ogechi Okolie, M.D
• Edidiong Macdonald Okon Ben, MD
• Victoria Okon
• Ben Okoro, RN
• Justin-David Elochukwu Okoro, MD
• Nnadozie Okoroafor, MD
• Kayla Ann Okray

• Family Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; 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.