Individual provider Active NPI

Obiageli Olofinmoyin, FNP

  • Family Nurse Practitioner
  • Richmond, TX
National Provider Identifier
1164190666
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1053063 Issued in TX
Practice address
18211 Palisade Rock CT
Richmond, TX 77407-5005
Phone
(832) 293-0050
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1053063 TX Primary

Addresses

Primary practice location

18211 Palisade Rock CT
Richmond, TX 77407-5005

Mailing address

18211 Palisade Rock CT
Richmond, TX 77407-5005
Phone (832) 293-0050

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
I20221107000392 TX Practitioner - Nurse Practitioner 1759662935 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CNG Home Health,Inc CurrentSince Sep 5, 2021 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jan 5, 2023 Accepting new patients
Advanced Primary Care House Calls Inc CurrentSince Dec 1, 2024 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: obiageli.olofinmoyin.1@28492.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
CNG Home Health,IncRichmond, TX, CCN 673198 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Director (100%)
W-2 Managing Employee
Oct 31, 2018
Oct 31, 2018
Oct 31, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1164190666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18211 PALISADE ROCK CT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774075005",
            "telephone_number": "832-293-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18211 PALISADE ROCK CT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774075005",
            "telephone_number": "832-293-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOFINMOYIN",
        "first_name": "OBIAGELI",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1053063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.