Individual provider Active NPI

Olayemi Ononogbu, APRN, FNP-C, PMHNP-B

  • Family Nurse Practitioner
  • Bedford, TX
National Provider Identifier
1003243379
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP124345 Issued in TX
Practice address
1305 Airport Fwy Ste 220
Bedford, TX 76021-6606
Phone
(817) 358-5800
NPI assigned
Oct 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP124345 TX Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP124345 TX

Addresses

Primary practice location

1305 Airport Fwy Ste 220
Bedford, TX 76021-6606

Mailing address

1305 Airport Fwy
Bedford, TX 76021-6605
Phone (817) 358-5800

Other practice location 1

5500 Southwestern Medical Ave
Dallas, TX 75235-7200
Phone (214) 689-6500

Other names 1

  • Olayemi Omotoso Former name

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
I20170502001168 TX Practitioner - Nurse Practitioner 8426335316 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1785 State Hwy 26
Suite 200
Grapevine, TX 76051-2217
Phone (833) 582-7792

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP124345TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lullabies Teentalk and Adult Psychiatric Wellness Center LLC Family CurrentSince Jun 1, 2024 Accepting new patients
Tri City Psychiatric Services, P.a. CurrentSince Aug 1, 2017 Accepting new patients

Locations

4232 Heritage Trace Pkwy
Fort Worth, TX 76244
Phone (817) 200-6680

1701 W Northwest Hwy
Ste 100
Grapevine, TX 76051
Phone (817) 416-1235

1785 State Highway 26
Ste 200
Grapevine, TX 76051
Phone (817) 300-4073

Organizations & group practices 2

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": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1003243379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 AIRPORT FWY",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216605",
            "telephone_number": "817-358-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 AIRPORT FWY STE 220",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216606",
            "telephone_number": "817-358-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5500 Southwestern Medical Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357200",
            "country_code": "US",
            "telephone_number": "214-689-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONONOGBU",
        "first_name": "OLAYEMI",
        "name_prefix": "Ms.",
        "credential": "APRN, FNP-C, PMHNP-B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2024-07-01",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP124345",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP124345",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLAYEMI",
            "last_name": "OMOTOSO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.