Kafayat Olateju Popoola, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1057732 Issued in TX

Practice address

207 N Union Ave Ste E
Roswell, NM 88201-3068

Phone

(575) 363-3189

Fax

(575) 363-3188

NPI assigned

Oct 28, 2024

Last updated

Mar 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpopoola1331060@ahs.direct-ci.com

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.

• The Phoenix Place PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mansfield, TX
  • NPI 1225976400
  NPD Authorized official
• Renew Health LLC

  • Nurse Practitioner
  • Roswell, NM
  • NPI 1336808831
  NPD
• Curednation LLC

  • Family Nurse Practitioner
  • Dallas, TX
  • NPI 1508587627
  NPD (past)

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1073335436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 VIRGINIA DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635510",
            "telephone_number": "346-235-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N UNION AVE STE E",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013068",
            "telephone_number": "575-363-3189",
            "fax_number": "575-363-3188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 US 287 Frontage Road",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "76001",
            "country_code": "US",
            "telephone_number": "346-235-7127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POPOOLA",
        "first_name": "KAFAYAT",
        "middle_name": "OLATEJU",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1057732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Platt
• Amanda Pollat
• Crysten Ann Louise Pope, MS.CCC-SLP
• Jason Taylor Pope, M.D.
• Victoria Pope
• Veronica Posuniak
• Brian Potocki
• Emily Jeanne Poynton
• Presbyterian Medical Services (Chaves County Home Visiting Program)
• Kathleen Renee Price, APRN - CNP

• Psychiatric/Mental Health Nurse Practitioner in Roswell, NM
• Providers in Roswell, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.