Individual provider Active NPI

Olapeju Fakeye

  • Psychiatric/Mental Health Nurse Practitioner
  • Plano, TX
National Provider Identifier
1124642327
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1014537 Issued in TX
Practice address
1255 W 15TH St Ste 815
Plano, TX 75075-4208
Phone
(972) 673-0404
NPI assigned
Jun 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 891088 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1014537 TX Primary

Addresses

Primary practice location

1255 W 15TH St Ste 815
Plano, TX 75075-4208

Mailing address

1255 W 15TH St Ste 815
Plano, TX 75075-4208

Other practice location 1

2021 S Jones Blvd
Las Vegas, NV 89146-3137
Phone (702) 202-0099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210316001393 TX Practitioner - Nurse Practitioner 2163838251 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
891088TXMDRegistered Nurse
1014537TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cerebral Medical Group, a Professional Corporation CurrentSince Sep 7, 2021 Accepting new patients
Kinghaven Counseling Group Inc CurrentSince Mar 8, 2021 Accepting new patients

Locations

340 S Lemon Ave
Ste 9892
Walnut, CA 91789
Phone (415) 617-9894

6315 Gulfton St
Ste 100
Houston, TX 77081
Phone (713) 457-4357

3025 E Renner Rd
Ste 120
Richardson, TX 75082
Phone (214) 257-0682

2007 N Collins Blvd
Ste 303
Richardson, TX 75080
Phone (972) 947-4112

Organizations & group practices 2

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": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1124642327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W 15TH ST STE 815",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750754208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W 15TH ST STE 815",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750754208",
            "telephone_number": "972-673-0404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 S Jones Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891463137",
            "country_code": "US",
            "telephone_number": "702-202-0099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAKEYE",
        "first_name": "OLAPEJU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2021-03-11",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "891088",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1014537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.