Individual provider Active NPI

Oluwatobi Olusholla Aruwajoye, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1073221040
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2022044161 Issued in MO
Practice address
3950 W Jordan St
Springfield, MO 65802-6768
Phone
(281) 661-0125
NPI assigned
Nov 9, 2022
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2022044161 MO Primary

Addresses

Primary practice location

3950 W Jordan St
Springfield, MO 65802-6768

Mailing address

3950 W Jordan St
Springfield, MO 65802-6768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230120000316 MO Practitioner - Nurse Practitioner 9638540149 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022044161MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carelinks LLC CurrentSince Jan 28, 2024 Accepting new patients
Springfield Psychiatry & Addiction Medicine LLC CurrentSince Jan 1, 2024 Accepting new patients
Eustasis Foundation, Inc PastSince Aug 30, 2020 Accepting new patients

Locations

1675 E Seminole St
Ste A1
Springfield, MO 65804
Phone (417) 557-2355

3646 S Campbell Ave
Springfield, MO 65807
Phone (417) 597-4309

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": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1073221040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 W JORDAN ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658026768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 W JORDAN ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658026768",
            "telephone_number": "281-661-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARUWAJOYE",
        "first_name": "OLUWATOBI",
        "middle_name": "OLUSHOLLA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2022044161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.