Active NPI
Omolara Y Okunfolami, NP
- Adult Health Nurse Practitioner
- Minnetonka, MN
National Provider Identifier
1144525924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- NPP37552
- Practice address
- 9900 Bren Rd E
Minnetonka, MN 55343-9664 - Phone
- (401) 408-3569
- NPI assigned
- Jan 25, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | NPP37552 | RI | Primary |
Addresses
Primary practice location
9900 Bren Rd E
Minnetonka, MN 55343-9664
Mailing address
34 Briarbrooke LN
Cranston, RI 02921-2111
Phone (401) 286-6784
Other practice location 1
225 Chapman St
Providence, RI 02905-4533
Phone (401) 490-6566 ext. 176
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10319 | CT | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matrix Medical Plus | Current | Accepting new patients |
Locations
9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883
1224 Mill St
Bldg B
East Berlin, CT 06023
Phone (860) 406-4894
3 Allied Dr
Dedham, MA 02026
Phone (404) 587-0945
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": "1295913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595894400000",
"number": "1144525924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 BRIARBROOKE LN",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029212111",
"telephone_number": "401-286-6784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 BREN RD E",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553439664",
"telephone_number": "401-408-3569"
}
],
"practiceLocations": [
{
"address_1": "225 Chapman St",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "RI",
"postal_code": "029054533",
"country_code": "US",
"telephone_number": "401-490-6566 x176",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OKUNFOLAMI",
"first_name": "OMOLARA",
"middle_name": "Y",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-25",
"last_updated": "2020-07-28",
"certification_date": "2020-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "RI",
"license": "NPP37552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.