Individual provider Active NPI

Opeyemi Olusola

  • Family Nurse Practitioner
  • Crowley, TX
National Provider Identifier
1063989119
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
06182542 Issued in TX
Practice address
13409 Hartland St
Crowley, TX 76036-1305
Phone
(214) 717-0454
NPI assigned
Oct 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 06182542 TX Primary

Addresses

Primary practice location

13409 Hartland St
Crowley, TX 76036-1305

Mailing address

13409 Hartland St
Crowley, TX 76036-1305
Phone (214) 717-0454

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
I20200513001982 TX Practitioner - Nurse Practitioner 6709217409 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark Lindemann DO PAGroup PAC ID 0840516662, 4 clinicians

Practice addresses (Care Compare)

4545 Bellaire Dr S
Suite 9
Fort Worth, TX 76109-1811
Phone (817) 763-8300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06182542TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Collin Medical & Wellness Group PLLC Family CurrentSince Jan 21, 2021 Accepting new patients
Post Acute Specialists of Texas PA Family CurrentSince Aug 1, 2022 Accepting new patients
Mark Lindemann DO PA CurrentSince Oct 11, 2024 Accepting new patients
Crystal Mind Psychiatry and Counseling PastSince Aug 13, 2023 Accepting new patients

Locations

2911 Medical Arts St
Ste 10
Austin, TX 78705
Phone (512) 474-5551

4545 Bellaire Dr S
Ste 9
Ft Worth, TX 76109
Phone (817) 732-6060

307 S McDonald St
Ste 500
McKinney, TX 75069
Phone (469) 202-7572

307 W Cypress St
San Antonio, TX 78212
Phone (210) 223-5521

Interoperability endpoints

  • Direct secure messaging: opeyemiolusola@usoapas.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHGIBD/Endpoint/IHGIBD
  • FHIR API: https://api.platform.athenahealth.com/25728/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1540512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1063989119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13409 HARTLAND ST",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760361305",
            "telephone_number": "214-717-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13409 HARTLAND ST",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760361305",
            "telephone_number": "214-717-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUSOLA",
        "first_name": "OPEYEMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-26",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "06182542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crowley, TX

Sources for this page

Verify at the official NPI Registry.