Modupe Mary Okonofua, PMHNP-BC, FNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0001591-C-NP Issued in CO

Practice address

3585 Van Teylingen Dr Ste D
Colorado Springs, CO 80917-4872

Phone

(719) 413-5005

Fax

(719) 413-5006

NPI assigned

Jan 9, 2015

Sex

Female

Sole proprietor

No

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, CO2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Diamond Global Healthcare IncGroup PAC ID 2466879713, 2 clinicians

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Diamond Global Healthcare, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1609340777
  Medicare reassignment Care Compare group Authorized official
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Cedar Springs Hospital, Inc

  • Psychiatric Hospital
  • Colorado Springs, CO
  • NPI 1992752133
  Medicare reassignment NPD
• Heart of Texas Region MHMR Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waco, TX
  • NPI 1639399132
  Medicare reassignment NPD
• Tri City Psychiatric Services, P.a.

  • Psychiatry Physician
  • Arlington, TX
  • NPI 1770764466

  Nurse Practitioner

  Medicare reassignment NPD
• Cedar Springs Hospital, Inc

  • Family Nurse Practitioner
  • Colorado Springs, CO
  • NPI 1477166833
  NPD

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1215325535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 VAN TEYLINGEN DR STE D",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809174872",
            "telephone_number": "719-413-5005",
            "fax_number": "719-413-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 VAN TEYLINGEN DR STE D",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809174872",
            "telephone_number": "719-413-5005",
            "fax_number": "719-413-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKONOFUA",
        "first_name": "MODUPE",
        "middle_name": "MARY",
        "credential": "PMHNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-09",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0001591-C-NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0001591-C-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goroh Okazaki, M.D.
• Deborah Elsie Okeke
• Kimberly Okinedo
• Harold Okocha
• Annette Okonofua, BCBA, M.ED.
• Chinna Okoroafor
• Andrew Agada Okpe, MD, MRCP(UK)
• Tayanita Olavarria
• Kasey Olceski
• Old Colorado City Wellness PLLC

• Psychiatric/Mental Health Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

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