Individual provider Active NPI

Rauf Boladale Emiola, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond, TX
National Provider Identifier
1104265818
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP123408 Issued in TX
Practice address
11122 Mineral Island LN
Richmond, TX 77406-1681
Phone
(832) 876-3626
NPI assigned
Jun 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP123408 TX
Family Nurse Practitioner 363LF0000X 751577 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61552322 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP123408 TX Primary

Addresses

Primary practice location

11122 Mineral Island LN
Richmond, TX 77406-1681

Mailing address

11122 Mineral Island LN
Richmond, TX 77406-1681
Phone (832) 876-3626

Other practice location 1

8303 Southwest Fwy Ste 555
Houston, TX 77074-1698
Phone (832) 876-3626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20250306000983 WA Practitioner - Nurse Practitioner 4587899265 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince Nov 16, 2024 Accepting new patients
Compassionate Care Associates Psychiatric/Mental Health CurrentSince Apr 28, 2024 Accepting new patients
Northwest Urgent Care Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1104265818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11122 MINERAL ISLAND LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774061681",
            "telephone_number": "832-876-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11122 MINERAL ISLAND LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774061681",
            "telephone_number": "832-876-3626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8303 Southwest Fwy Ste 555",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770741698",
            "country_code": "US",
            "telephone_number": "832-876-3626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMIOLA",
        "first_name": "RAUF",
        "middle_name": "BOLADALE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP123408",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "751577",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61552322",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP123408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.