Mayowa Mary Otuada

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

1114753 Issued in TX

Practice address

400 Rosalind Redfern Grover Pkwy
Midland, TX 79701-5846

Phone

(432) 681-3100

NPI assigned

Mar 16, 2021

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1992380349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ROSALIND REDFERN GROVER PKWY",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015846",
            "telephone_number": "432-681-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ROSALIND REDFERN GROVER PKWY",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015846",
            "telephone_number": "432-681-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTUADA",
        "first_name": "MAYOWA",
        "middle_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "1114753",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1174310",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ortho Midland PA Affiliates, PLLC
• Orthopaedic Center of Midland, PLLC
• Kayla M Ott, PA-C
• Martha Ottinger, COTA
• Ottriss Complete Care LLC
• Daren Jean Overmiller, D.C.
• Omotade Oyebanji, PMHNP
• P Douglas Cochran MD PA
• Miguel Pacheco
• McKenzie Pack

• Women's Health Nurse Practitioner in Midland, TX
• Providers in Midland, TX by specialty
• Women's Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.