DR. OMOTOLA WASILAT DANMOLE-ODIMAYO (FNP-BC, DNP) – Psychiatric/Mental Health Registered Nurse, NPI 1619179041
Psychiatric/Mental Health Registered Nurse
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,703 NURSE PRACTITIONER in IL
Provider Addresses for DR. OMOTOLA WASILAT DANMOLE-ODIMAYO (FNP-BC, DNP)
5850 6TH STREET FRONTAGE RD E STE A
SPRINGFIELD, IL 627035194
Phone: (217) 529-5046
Fax: (217) 529-6154
Type: Location
5850 6th Street Frontage Rd E Ste A
Springfield, IL 627035194
Phone: (217) 529-5046
Fax: (217) 529-6154
Type: Location
7011 Preston Dr
Springfield, IL 627114310
Phone: (217) 553-0266
Type: Location
7011, Preston Drive, Springfield, Sangamon County, Illinois, 62711, United States
SPRINGFIELD, IL 627114310
Phone: (217) 553-0266
Type: Mailing
2041 W ILES AVE STE C
SPRINGFIELD, IL 627047006
Phone: (217) 718-2910
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-07-14
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080714000466 | I | Nurse Practitioner | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62703)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | IL |
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