Ibukun Ajoke Fagbuyi, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

266910 Issued in AZ

Practice address

13838 S 46TH PL Ste 340
Phoenix, AZ 85044-7805

Phone

(480) 597-7903

NPI assigned

Nov 20, 2021

Last updated

Jan 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ibukun Ajoke Oni Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peoples Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Goodyear, AZ
  • NPI 1366131351
  NPD Authorized official
• Peoples Mental Health LLC

  • Clinic/Center
  • Glendale, AZ
  • NPI 1063130086
  Authorized official Same address or phone
• Premium Legacy Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1184327249
  NPD (past)

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

{
    "created_epoch": "1637366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1174280549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9429 W OREGON AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053352",
            "telephone_number": "301-785-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13838 S 46TH PL STE 340",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447805",
            "telephone_number": "480-597-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGBUYI",
        "first_name": "IBUKUN",
        "middle_name": "AJOKE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-20",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "266910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "info@bethelhillsintegrated.com",
            "affiliation": "N",
            "address_1": "13838 S 46th Pl Ste 340",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850447805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "IBUKUN",
            "last_name": "ONI",
            "middle_name": "AJOKE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Siobhan Emily Faenza, MD
• Charlotte Moffett Fafard, RN.
• Alyssa L Fagan-Clark, LCSW
• Jade Elise Fagan, PT
• Joseph Michael Fagan, LMSW
• Sarita Fager, MA, LPC
• Chris David Fagerlie
• Seth Alfred Fagerlie, MD
• Mauhasin J Fagg-Daves
• Megan Kimi Fah, MD, MPH

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.

Verify at the official NPI Registry.