Individual provider Active NPI

Christopher Afolabi Ajadi, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Sugar Land, TX
National Provider Identifier
1467177410
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10743 Issued in CT
Practice address
9415 Jowett PL
Sugar Land, TX 77498-7585
Phone
(832) 630-6014
NPI assigned
Oct 11, 2022
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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 10743 CT Primary

Addresses

Primary practice location

9415 Jowett PL
Sugar Land, TX 77498-7585

Mailing address

9415 Jowett PL
Sugar Land, TX 77498-7585
Phone (832) 630-6014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230123002530 WA Practitioner - Nurse Practitioner 4284005604 Reassigns benefits to 2 organizations
Practice locations: Everett, WA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

21907 64TH Ave W
Suite 200
Mountlake Terrace, WA 98043-6200
Phone (425) 640-7009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10743CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vest Seattle, LLC Single Specialty CurrentSince Dec 19, 2022 Accepting new patients
Cafjad Behavioral Healthcare LLC Single Specialty CurrentSince Apr 14, 2024 Accepting new patients
Mindful Therapy Group PC Single Specialty CurrentSince Aug 11, 2024 Accepting new patients

Locations

1710 100th Pl SE
Ste D101
Everett, WA 98208
Phone (409) 888-9785

3955 156th St NE
Marysville, WA 98271
Phone (719) 660-2696

21907 64th Ave W
Ste 200
Mountlake Terrace, WA 98043
Phone (410) 258-3698

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

320 NE 97th St
Ste A
Seattle, WA 98115
Phone (206) 323-8113

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1467177410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9415 JOWETT PL",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774987585",
            "telephone_number": "832-630-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 JOWETT PL",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774987585",
            "telephone_number": "832-630-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJADI",
        "first_name": "CHRISTOPHER",
        "middle_name": "AFOLABI",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "10743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.