MICKEY TEEMNAH OMOLE (NPI# 1598182958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598182958 |
| Entity Type | Individual |
| Full Name | MICKEY TEEMNAH OMOLE |
| Credential | FNP |
| Practice Address |
301 University Blvd Galveston TX 77555-1974 |
| Mailing Address |
1835 Dixie Hwy Suite 100 Flossmoor IL 60422-1974 |
| Practice Telephone | 4097722222 |
| Mailing Telephone | 7087998384 |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2020-04-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP132358 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
301 UNIVERSITY BLVD |
| City | GALVESTON |
| State | TX |
| Zip Code | 77555-1974 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396742714 | Bagi Rp Jana | Internal Medicine | 301 University Blvd, Galveston, TX 77555-0565 | 2005-06-30 |
| 1023617685 | Kimberly Joy Staton | Nurse Practitioner | 301 University Blvd, Galveston, TX 77555-5303 | 2020-10-23 |
| 1295333185 | Adelina Mun See Leong | Physician Assistant | 301 University Blvd, Galveston, TX 77555-3205 | 2020-10-13 |
| 1245838341 | Zachary Allen Helmick | Physician Assistant | 301 University Blvd, Galveston, TX 77555-5302 | 2020-10-12 |
| 1477150795 | Mason Juehon Yu | Physician Assistant | 301 University Blvd, Galveston, TX 77555-5302 | 2020-10-09 |
| 1336746866 | Hillary Mai | Physician Assistant | 301 University Blvd, Galveston, TX 77555-5302 | 2020-10-07 |
| 1699380139 | Sanjai Naicheril Sabu | Physician Assistant | 301 University Blvd, Galveston, TX 77555-5302 | 2020-09-11 |
| 1497369409 | Olusola Sogbein | Internal Medicine | 301 University Blvd, Galveston, TX 77555-0562 | 2020-09-08 |
| 1801409636 | Anand Kumar | Internal Medicine | 301 University Blvd, Galveston, TX 77555-0100 | 2020-08-31 |
| 1235748633 | Youlanda Martin-jones | Family Medicine | 301 University Blvd, Galveston, TX 77555-5302 | 2020-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053963389 | Ruba Riachy | Internal Medicine | The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555 | 2019-07-16 |
| 1700362670 | Nidal Alhosainat | Internal Medicine | 301 University Blvd, 4.200 John Sealy Annex, Galveston, TX 77555 | 2018-07-13 |
| 1275915282 | Murtaza Mazhar | Internal Medicine | 301 University Blvd Cardiovascular Disease, Galveston, TX 77555 | 2015-06-25 |
| 1124469531 | Nisarg Shaileshbhai Shah | Internal Medicine | 400 Harborside Dr Suite #100, Endocrinology, Galveston, TX 77555 | 2013-07-13 |
| 1912260860 | Mohammed Fathi Zaidan | Internal Medicine | University of Texas Medical, 301 University Boulevard, Galveston, TX 77555 | 2012-06-15 |
| 1639465925 | Justin Blinn | Anesthesiology | 301 University Blvd # 2-a, Galveston, TX 77555 | 2011-06-24 |
| 1255532982 | Miguel Mauricio Cabada Samame | Internal Medicine | 301 University Boulevard Rt 0435, Galveston, TX 77555 | 2007-05-30 |
| 1154945608 | Elliot Blankespoor | Anesthesiology | 301 University Boulevard, 5.504 Jennie Sealy Hospital, Galveston, TX 77555 | 2020-06-01 |
| 1932699972 | Sara Medsker | Pediatrics | 301 University Blvd., Galveston, TX 77555 | 2018-05-15 |
| 1134297666 | Donna B Weaver | Family Medicine | 400 Harborside Dr, Galveston, TX 77555 | 2006-12-01 |
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| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487153672 | Lili Chen | Nurse Practitioner | 1005 Harborside Drive 3rd Floor, Galveston, TX 77555-0001 | 2018-02-02 |
| 1992119705 | Cynthia Holmes | Nurse Practitioner | 2218 Grover Ave, Galveston, TX 77551-1429 | 2014-06-19 |
| 1811557119 | Lauren Marisa Perez | Nurse Practitioner | 301 University Blvd, Galveston, TX 77555-5302 | 2019-06-18 |
| 1396308946 | Su Chen | Nurse Practitioner | 301 University Blvd, Galveston, TX 77555-4399 | 2019-04-19 |
| 1255892527 | Ashley Kay Mcveigh | Nurse Practitioner | 301 University Blvd, Galveston, TX 77555-5302 | 2019-03-28 |
| 1346728185 | Sinju Jacob | Nurse Practitioner | 301 University Blvd, Galveston, TX 77555-5302 | 2018-08-03 |
| 1053807768 | Stacy Janices Aguirre | Nurse Practitioner | 400 Harborside, Galveston, TX 77550 | 2018-07-05 |
| 1730624073 | Anne Nance | Nurse Practitioner | 301 University Blvd, Galveston, TX 77555-5302 | 2016-12-22 |
| 1689126385 | Leona Machele Chaljub | Nurse Practitioner | 301 University Blvd, Galveston, TX 77555 | 2016-10-28 |
| 1053771097 | Marisa Cueva | Nurse Practitioner | 301 University Blvd, Galveston, TX 77555-5302 | 2016-03-03 |
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| 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.