Mine Divine Health LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MINE DIVINE HEALTH LLC

Practice address

132 SE Chelsea CT # Lee
Lees Summit, MO 64063-2472

Phone

(816) 217-2076

NPI assigned

Oct 9, 2025

Organization subpart

No

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

Authorized official

Name

Adesuwa ObasogieNPI 1518687110

Title

Ceo/Owner

Phone

(816) 217-2076

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adesuwa Lillian Obasogie, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Kansas City, MO
  • NPI 1518687110

  KS

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1759968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1326913294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 SE CHELSEA CT # LEE",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 SE CHELSEA CT # LEE",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632472",
            "telephone_number": "816-217-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINE DIVINE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-09",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "OBASOGIE",
        "authorized_official_first_name": "ADESUWA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "816-217-2076"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.