Johnson Komolafe, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R123830 Issued in MD

Practice address

7011 Calamo St
#105
Springfield, VA 22150

Phone

(301) 670-4250

NPI assigned

Jul 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Benjamin a. Adewale MD PC

  dba Riverside Mental and Medical Clinic

  • Mental Health Counselor
  • Alexandria, VA
  • NPI 1992073084
  NPD (past)
• Benjamin Adewale MD PC

  dba Riverside Mental Health LLC

  • Neurology Physician
  • Springfield, VA
  • NPI 1821015264
  NPD (past)
• Crawford Consulting and Mental Health Services, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Cheverly, MD
  • NPI 1508805953
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174540504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8057",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223068057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 CALAMO ST",
            "address_2": "#105",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "22150",
            "telephone_number": "301-670-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMOLAFE",
        "first_name": "JOHNSON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R123830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Donald Knox, MD
• Lorena Yuvette Knox
• Stephanie Koch, MA CF-SLP
• Emily Anne Kohut, RBT
• Meihannah Y Kolb, DPT, PT
• Lauren Koontz, LCSW
• Kora Analysis, LLC
• Maria Korossy, SLP
• Kapil Kotadia, DDS
• Mai Koussa, DDS

• Psychiatric/Mental Health Nurse Practitioner in Springfield, VA
• Providers in Springfield, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.