KEYAMO M OMOKURU (NPI# 1295066694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295066694 |
| Entity Type | Individual |
| Full Name | KEYAMO M OMOKURU |
| Credential | DNP, PMHNP-BC |
| Practice Address |
928 W Commerce St San Antonio TX 78207-4444 |
| Mailing Address |
6800 Park Ten Blvd Ste 200s San Antonio TX 78213-4293 |
| Practice Telephone | 2102611250 |
| Practice Fax Number | 2104340716 |
| Mailing Telephone | 2102611000 |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2019-05-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 164W00000X | Licensed Practical Nurse | PN 19805 | OH | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP141260 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7563 Black Squirrel Trl, Hamilton, OH 450117613 | 5138077507 |
| Street Address |
928 W COMMERCE ST |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78207-4444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689631053 | Zenaida Eclarinal | Psychiatry & Neurology | 928 W Commerce St, San Antonio, TX 78207-4444 | 2006-04-28 |
| 1629547898 | Teresa Dawn Harper | Nurse Practitioner | 928 W Commerce St, San Antonio, TX 78207-4444 | 2018-11-17 |
| 1346752524 | Allan Francis Tejada | Nurse Practitioner | 928 W Commerce St, San Antonio, TX 78207-4444 | 2017-10-28 |
| 1285177659 | Karen Inzurriaga | Registered Nurse | 928 W Commerce St, San Antonio, TX 78207-4444 | 2016-12-02 |
| 1497195481 | Mohammad Junaid Javed | Psychiatry & Neurology | 928 W Commerce St, San Antonio, TX 78207-4444 | 2013-07-05 |
| 1255778999 | Jenny Jesus Rodriguez | Counselor | 928 W Commerce St, San Antonio, TX 78207-4444 | 2013-06-03 |
| 1841473816 | Michelle Mercado | Psychiatry & Neurology | 928 W Commerce St, San Antonio, TX 78207-4444 | 2007-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457999849 | Eri Industries, LLC, Dba Eri Group Homes | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2300 W. Commerce#216, San Antonio, TX 78207 | 2019-12-16 |
| 1164087854 | Jesse G Trevino | Student in an Organized Health Care Education/Training Program | 700 S Zarzamora Ste 209, San Antonio, TX 78207 | 2019-05-08 |
| 1669036869 | Anjali Patel | Student in an Organized Health Care Education/Training Program | 903 W. Martin Street, San Antonio, TX 78207 | 2019-04-24 |
| 1811488257 | Thomas Ellis Tippit Sr. | Dentist | 711 North Frio St, San Antonio, TX 78207 | 2018-05-22 |
| 1619426053 | Erica Annotti | Nurse Practitioner | 903 W Martin St Fl 6, San Antonio, TX 78207 | 2016-09-27 |
| 1801255435 | Mona Anwar El-kady | Audiologist | 411 S.w. 24th St, Jersig Building J119, San Antonio, TX 78207 | 2016-02-10 |
| 1053785683 | Lisa Marie Ramos | Speech-Language Pathologist | 230 Rounds, San Antonio, TX 78207 | 2015-11-19 |
| 1568840221 | Gabriel Tamayo | Physical Therapist | 701 S Zarzarmora, San Antonio, TX 78207 | 2015-05-14 |
| 1588042717 | Priya Amin | Podiatrist | 701 S Zarzamora St Ste 2120, San Antonio, TX 78207 | 2015-05-07 |
| 1437545837 | Jesse Banales | Student in an Organized Health Care Education/Training Program | 333 North Santa Road, Ccf-f3725, San Antonio, TX 78207 | 2015-04-13 |
| Find all providers in zip 78207 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225643968 | Britanni O Greene | Nurse Practitioner | 10650 Culebra Rd # 104-548, San Antonio, TX 78251-4949 | 2020-09-10 |
| 1356955462 | Saeid Nekoueian | Nurse Practitioner | 19506 Flair Oak, San Antonio, TX 78258-3648 | 2020-09-04 |
| 1649806282 | Monique Straker | Nurse Practitioner | 9480 Huebner Rd Ste 210, San Antonio, TX 78240-1657 | 2020-03-16 |
| 1245864396 | Jordan Nichole Davis | Nurse Practitioner | 7035 Pickwell Dr Apt 2100, San Antonio, TX 78223-3385 | 2020-02-27 |
| 1447714274 | Suzanne Perakathu | Nurse Practitioner | 7122 Stonewall Hill, San Antonio, TX 78256 | 2019-01-25 |
| 1023536612 | Olena Shvets | Nurse Practitioner | 311 Camden St # 510, San Antonio, TX 78215-2012 | 2017-09-02 |
| 1528598620 | Dianne Lavin LLC | Nurse Practitioner | 503 Benedict Ct, San Antonio, TX 78258-2545 | 2017-06-13 |
| 1699215293 | Monique Gonzalez | Nurse Practitioner | 311 Camden St., Suite 510, San Antonio, TX 78215 | 2017-03-01 |
| 1215476940 | Vita T Chung | Nurse Practitioner | 8122 Datapoint Dr Ste 1000, San Antonio, TX 78229-3273 | 2017-02-14 |
| 1629512926 | Mark Evans | Nurse Practitioner | 311 Camden St Ste 606, San Antonio, TX 78215-2016 | 2016-12-06 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78207 |
Please comment or provide details below to improve the information on KEYAMO M OMOKURU.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.