Individual provider Active NPI

Esther Fakayode, NURSE PRACTIONER

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Clemmons, NC
National Provider Identifier
1194525857
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
244578 Issued in NC
Practice address
850 Boyer Dr
Clemmons, NC 27012-8856
Phone
(336) 682-3565
NPI assigned
Mar 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 244578 NC Primary

Addresses

Primary practice location

850 Boyer Dr
Clemmons, NC 27012-8856

Mailing address

850 Boyer Dr
Clemmons, NC 27012-8856
Phone (336) 682-3565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
244578NCMDPsychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1194525857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 BOYER DR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128856",
            "telephone_number": "336-682-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 BOYER DR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128856",
            "telephone_number": "336-682-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKAYODE",
        "first_name": "ESTHER",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NC",
            "license": "244578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.