Individual provider Active NPI

Adegboyega Omoba, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cedar Hill, TX
National Provider Identifier
1144713611
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP137736 Issued in TX
Practice address
1141 Wishing Well CT
Cedar Hill, TX 75104-8255
Phone
(682) 560-0666
Fax
(817) 422-0781
NPI assigned
Jun 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 840719 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN.0001960-C-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2639996 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP137736 TX Primary

Addresses

Primary practice location

1141 Wishing Well CT
Cedar Hill, TX 75104-8255

Mailing address

1141 Wishing Well CT
Cedar Hill, TX 75104-8255
Phone (682) 560-0666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190510000277 TX Practitioner - Nurse Practitioner 1557604790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

607 E Abram St
Suite 9
Arlington, TX 76010-1206
Phone (682) 560-0666

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
840719TXMDRegistered Nurse
2639996AZMDPsychiatric/Mental Health Nurse Practitioner
C-APN.0001960-C-NPCOMDPsychiatric/Mental Health Nurse Practitioner
AP137736TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Behavorial Health Corporation Psychiatric/Mental Health CurrentSince May 1, 2019 Accepting new patients
Behavioral Health of North Texas LLP CurrentSince Sep 1, 2019 Accepting new patients

Locations

800 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 548-6100

607 E Abram St
Arlington, TX 76010
Phone (682) 560-0666

607 E Abram St
Ste 9
Arlington, TX 76010
Phone (682) 560-0666

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

2717 Tibbets Dr
Bedford, TX 76022
Phone (817) 685-4011

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

5858 Main St
Ste 200
Frisco, TX 75033
Phone (214) 619-0721

240 N Miller Rd
Mansfield, TX 76063
Phone (214) 432-8322

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

6110 W Parker Rd
Plano, TX 75093
Phone (214) 369-5522

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1144713611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 WISHING WELL CT",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751048255",
            "telephone_number": "682-560-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 WISHING WELL CT",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751048255",
            "telephone_number": "682-560-0666",
            "fax_number": "817-422-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOBA",
        "first_name": "ADEGBOYEGA",
        "name_prefix": "Mr.",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "840719",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0001960-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "2639996",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP137736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Hill, TX

Sources for this page

Verify at the official NPI Registry.