Individual provider Active NPI

Olivia Ajeakwa, FNP

  • Family Nurse Practitioner
  • Rancho Cordova, CA
National Provider Identifier
1083171946
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95006695 Issued in CA
Practice address
12661 Thornberg Way
Rancho Cordova, CA 95742-7838
Phone
(916) 360-1883
NPI assigned
Feb 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 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 95006695 CA Primary

Addresses

Primary practice location

12661 Thornberg Way
Rancho Cordova, CA 95742-7838

Mailing address

1568 Creekside Dr Ste 203
Folsom, CA 95630-3449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95006695CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellestar Home Health Care, Inc CurrentSince Jul 24, 2022 Accepting new patients

Locations

1568 Creekside Dr
Ste 203
Folsom, CA 95630
Phone (916) 693-6677

Organizations & group practices 1

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": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1083171946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 CREEKSIDE DR STE 203",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12661 THORNBERG WAY",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "957427838",
            "telephone_number": "916-360-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJEAKWA",
        "first_name": "OLIVIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.