Individual provider Active NPI

Titilope Odunmorayo Witemire

  • Family Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1992563654
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023207404 Issued in TX
Practice address
7248 Portillo
Grand Prairie, TX 75054-0073
Phone
(682) 564-4685
NPI assigned
Mar 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2023207404 TX Primary

Addresses

Primary practice location

7248 Portillo
Grand Prairie, TX 75054-0073

Mailing address

7248 Portillo
Grand Prairie, TX 75054-0073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250630002276 TX Practitioner - Nurse Practitioner 1951814383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Baylor College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perioperative and Transitional Medicine Group PLLCGroup PAC ID 7214245646, 34 clinicians

Practice addresses (Care Compare)

8220 Walnut Hill LN
Suite 600
Dallas, TX 75231-4433
Phone (214) 238-3074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2023207404TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Perioperative and Transitional Medicine Group PLLC Family CurrentSince Jan 12, 2026 Accepting new patients
Kelsom Clinic PA CurrentSince Jun 1, 2025 Accepting new patients
Rava Healthcare LLC Family Current Accepting new patients

Locations

8220 Walnut Hill Ln
Ste 600
Dallas, TX 75231
Phone (214) 238-3074

1202 W Pioneer Dr
Ste 100
Irving, TX 75061
Phone (972) 254-7272

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1992563654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7248 PORTILLO",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750540073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7248 PORTILLO",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750540073",
            "telephone_number": "682-564-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITEMIRE",
        "first_name": "TITILOPE",
        "middle_name": "ODUNMORAYO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "2023207404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.