Olubukola E Shodiya

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209.020728 Issued in IL

Practice address

2921 Landmark PL Ste 215
Madison, WI 53713-4248

Phone

(708) 713-1017

NPI assigned

Jan 21, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Encounter Telehealth IncGroup PAC ID 9931348307, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Encounter Telehealth, Inc

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1922342195

  IL, Single Specialty, WI

  Medicare reassignment Care Compare group NPD
• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452

  Single Specialty

  Medicare reassignment NPD
• BH Care LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lockport, IL
  • NPI 1942811930

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1104456961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16514 S SUN MEADOW DR",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604415078",
            "telephone_number": "708-713-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 LANDMARK PL STE 215",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537134248",
            "telephone_number": "708-713-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHODIYA",
        "first_name": "OLUBUKOLA",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "115698",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "1681833",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71013331A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.020728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI APRN",
            "identifier": "1681833",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN APRN",
            "identifier": "71013331A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDFPR",
            "identifier": "209.020728",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Elise Shively, DPT, PT
• Jacklyn Shivers, MSSW
• Prakriti Shiwakoti, PHARMD
• Shami Shlomo, PAC
• Daniel Shmakov, CAA
• Bethany Marie Shoemaker, SAC-IT
• Cassandra Rae Shoemaker
• Nancy Allen Shook, RN, LCSW, APNP
• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co LLC

• Psychiatric/Mental Health Nurse Practitioner in Madison, WI
• Providers in Madison, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.