Olaitan Adesola Eboda, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ01343700 Issued in NJ

Practice address

811 Church Rd Ste 219
Cherry Hill, NJ 08002-1460

Phone

(732) 372-5963

NPI assigned

Jul 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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.

• Rhapsody Healthcare System LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cherry Hill, NJ
  • NPI 1265150718

  Single Specialty

  Medicare reassignment NPD Authorized official
• Counseling Center at Clark, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Clark, NJ
  • NPI 1245637578

  Single Specialty

  Medicare reassignment NPD
• Counseling Center at Freehold LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Freehold, NJ
  • NPI 1013269216

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1114652138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 CHURCH RD STE 219",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080021460",
            "telephone_number": "732-372-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 CHURCH RD STE 219",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080021460",
            "telephone_number": "732-372-5963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2386 Morris Ave # 107-109",
            "address_purpose": "LOCATION",
            "city": "Union",
            "state": "NJ",
            "postal_code": "070835723",
            "country_code": "US",
            "telephone_number": "732-372-5963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBODA",
        "first_name": "OLAITAN",
        "middle_name": "ADESOLA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NJ",
            "license": "26NJ01343700",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01343700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ear, Nose & Throat Surgical Associates, P.a.
• Melissa Eaton
• Katherine E Eber, SLP
• Kara Janos Eberhardt
• Briana Ebie
• Eckerd Corporation
• Ashley Eckett
• Tricia M Eddis, OTR/L
• Thomas J Edger, PT, DPT
• John E Edwards, PT

• Psychiatric/Mental Health Nurse Practitioner in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.