Individual provider Active NPI

Olanike Katibi, APRN-FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1063712081
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP136598 Issued in TX
Practice address
1100 NW Loop 410 Ste 700
San Antonio, TX 78213-2258
Phone
(210) 441-6024
Fax
(210) 783-8321
NPI assigned
Oct 25, 2010
Last updated
Mar 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 136598 TX
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X AP136598 TX
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X AP136598 TX Primary

Addresses

Primary practice location

1100 NW Loop 410 Ste 700
San Antonio, TX 78213-2258

Mailing address

1100 NW Loop 410 Ste 700
San Antonio, TX 78213-2258
Phone (210) 441-6024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180711003553 TX Practitioner - Nurse Practitioner 1153677794 Reassigns benefits to 1 organization
I20220404001713 NM Practitioner - Nurse Practitioner 1153677794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1802 NE Loop
410 Suite 515
San Antonio, TX 78217-5206
Phone (210) 441-6024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136598TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Live Oak Psychiatric and Family Practice, PLLC Multi-Specialty CurrentSince Sep 1, 2021 Accepting new patients
Behavioral Health Services of New Mexico LLC Multi-Specialty Current Accepting new patients
Behavioral Health Services of New Mexico LLC CurrentSince Mar 28, 2022 Accepting new patients

Locations

1525 N Renaissance Blvd NE
Albuquerque, NM 87107
Phone (505) 243-3387

1100 NW Loop 410
Ste 700
San Antonio, TX 78213
Phone (210) 241-4954

1802 NE Loop 410
Ste 515
San Antonio, TX 78217
Phone (210) 441-6024

Interoperability endpoints

  • Direct secure messaging: okatibi1916089@nychhc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1063712081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NW LOOP 410 STE 700",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132258",
            "telephone_number": "210-441-6024",
            "fax_number": "210-783-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NW LOOP 410 STE 700",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132258",
            "telephone_number": "210-441-6024",
            "fax_number": "210-783-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATIBI",
        "first_name": "OLANIKE",
        "credential": "APRN-FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "136598",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136598",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP136598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.