Individual provider Active NPI

Jacquelyn Okafor, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1194662908
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
296240 Issued in NC
Practice address
648 Hanes Mall Blvd
PMB 130
Winston Salem, NC 27103-5670
Phone
(336) 774-6641
NPI assigned
Apr 30, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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 Nurse Practitioner 363LP0808X 296240 NC Primary

Addresses

Primary practice location

648 Hanes Mall Blvd
PMB 130
Winston Salem, NC 27103-5670

Mailing address

648 Hanes Mall Blvd
PMB 130
Winston Salem, NC 27103-5670
Phone (336) 774-6641

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
296240NCMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1777507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1194662908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 HANES MALL BLVD",
            "address_2": "PMB 130",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035670",
            "telephone_number": "336-774-6641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 HANES MALL BLVD",
            "address_2": "PMB 130",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035670",
            "telephone_number": "336-774-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKAFOR",
        "first_name": "JACQUELYN",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-30",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "296240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.