Organization Active NPI

Graceful Olives Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Oakland, MD
National Provider Identifier
1407617319
Registry record updated Jul 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GRACEFUL OLIVES HEALTH
Practice address
5000 Thayer Ctr Ste C
Oakland, MD 21550-1139
Phone
(315) 547-0502
Fax
(727) 382-0311
NPI assigned
Jan 18, 2024
Last updated
Jul 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2026

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

Authorized official

Name
Ugochi Nwanyietodi Nwaobi, PMHNPNPI 1780237156
Title
Owner
Phone
(352) 286-9347

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

5000 Thayer Ctr Ste C
Oakland, MD 21550-1139

Mailing address

8403 Pines Blvd # 1440
Pembroke Pines, FL 33024-6609
Phone (954) 597-5957

Other practice location 1

1411 SW 97th Ave
Pembroke Pnes, FL 33025-3685
Phone (352) 286-9347

Other practice location 2

5742 W Hallandale Beach Blvd
West Park, FL 33023-5272
Phone (954) 710-9062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO, MD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20240528000779 FL Part B Supplier - Clinic/Group Practice 2365884079 Receives reassigned benefits from 1 practitioner
Practice locations: Pembroke Pines, FL
O20240930003516 CO Part B Supplier - Clinic/Group Practice 2365884079 Receives reassigned benefits from 1 practitioner
Practice locations: Boulder, CO
O20241205003784 MD Part B Supplier - Clinic/Group Practice 2365884079 Receives reassigned benefits from 1 practitioner
Practice locations: Oakland, MD

National Provider Directory

National Provider Directory

Locations

1500 N Grant St
Ste 8056
Denver, CO 80203

8403 Pines Blvd
Pembroke Pines, FL 33024
Phone (954) 551-4400

5742 W Hallandale Beach Blvd
West Park, FL 33023
Phone (954) 710-9062

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784332800000",
    "number": "1407617319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8403 PINES BLVD # 1440",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246609",
            "telephone_number": "954-597-5957",
            "fax_number": "954-405-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 THAYER CTR STE C",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501139",
            "telephone_number": "315-547-0502",
            "fax_number": "727-382-0311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 SW 97th Ave",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pnes",
            "state": "FL",
            "postal_code": "330253685",
            "country_code": "US",
            "telephone_number": "352-286-9347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5742 W Hallandale Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "West Park",
            "state": "FL",
            "postal_code": "330235272",
            "country_code": "US",
            "telephone_number": "954-710-9062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRACEFUL OLIVES HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2026-07-18",
        "certification_date": "2026-07-18",
        "status": "A",
        "authorized_official_last_name": "NWAOBI",
        "authorized_official_first_name": "UGOCHI",
        "authorized_official_middle_name": "NWANYIETODI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-286-9347",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2026; 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.