Stephanie Omotayo, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP135407 Issued in TX

Practice address

1626 W Highway 287 Business Ste 104
Waxahachie, TX 75165-4728

Phone

(469) 414-2615

Fax

(469) 242-9743

NPI assigned

Dec 9, 2017

Reactivated

Feb 7, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.omotayo@hca7.eclinicaldirectplus.com

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.

• Imperialhealth Clinic PLLC

  dba IMPERIAL Health Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Waxahachie, TX
  • NPI 1699346494
  Medicare reassignment NPD Authorized official
• Imperialhealth Clinic PLLC

  dba Imperial Health Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Waxahachie, TX
  • NPI 1306662010

  Family

  NPD Authorized official

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

{
    "created_epoch": "1512777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1184139362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 W HIGHWAY 287 BUSINESS STE 104",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751654728",
            "telephone_number": "469-414-2615",
            "fax_number": "469-242-9743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 W HIGHWAY 287 BUSINESS STE 104",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751654728",
            "telephone_number": "469-414-2615",
            "fax_number": "469-242-9743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOTAYO",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-09",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "deactivation_date": "2017-12-19",
        "reactivation_date": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP135407",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135407",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jideofor Uzoma Ogbonna, NP
• Justine G Ogoti
• Maria Eva Olan-Rogers
• Jennifer Oliver, M.S., CCC/SLP
• Olabisi Tokunbo Omehe
• Onyx Hill Company, LLC
• Open Doors RCH/Adcc/LLC (Open Doors Adult Day Care Center)
• Orthotx, PLLC (Arlington Orthopedic Associates)
• Charles Ray Osborn, M.D. D.C.
• Marisarose Osborn, LVN

• Psychiatric/Mental Health Nurse Practitioner in Waxahachie, TX
• Providers in Waxahachie, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.