Individual provider Active NPI

Jubril Omolaja

  • Psychiatric/Mental Health Nurse Practitioner
  • Forney, TX
National Provider Identifier
1346154671
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2026018264 Issued in TX
Practice address
2103 Ozarks CT
Forney, TX 75126-7789
Phone
(347) 575-1679
NPI assigned
Oct 2, 2026
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 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 2026018264 TX Primary

Addresses

Primary practice location

2103 Ozarks CT
Forney, TX 75126-7789

Mailing address

2103 Ozarks CT
Forney, TX 75126-7789

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1346154671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 OZARKS CT",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751267789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 OZARKS CT",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751267789",
            "telephone_number": "347-575-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOLAJA",
        "first_name": "JUBRIL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "2026018264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.