Deidre Opoku, MSN, CNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.0029532 Issued in OH

Practice address

7664 Slate Ridge Blvd
Reynoldsburg, OH 43068-8158

Phone

(614) 710-0173

Fax

(614) 987-4032

NPI assigned

Oct 26, 2011

Last updated

Jan 1, 2024By the provider in NPPES

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

Other names 1

• Deidre Gillespie Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science - Nursing

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amazing Grace Mental Wellness Care

  • Psychiatric/Mental Health Nurse Practitioner
  • Reynoldsburg, OH
  • NPI 1972236636
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704067200000",
    "number": "1598041287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7664 SLATE RIDGE BLVD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430688158",
            "telephone_number": "614-710-0173",
            "fax_number": "614-987-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7664 SLATE RIDGE BLVD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430688158",
            "telephone_number": "614-710-0173",
            "fax_number": "614-987-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPOKU",
        "first_name": "DEIDRE",
        "credential": "MSN, CNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2024-01-01",
        "certification_date": "2024-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0029532",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "303997",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEIDRE",
            "last_name": "GILLESPIE",
            "credential": "MSN, RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Olanrewaju O Olusemo, NURSING ASSISTANT
• Olubukola Grace Olusemo, RN
• Fartun Hassan Omar
• One Log Home Health Agency Services, Corporation
• Elizabeth Onyango
• Halle Michelle Orlinski, PHARMD
• Alfreda Osei-Mensah
• Wosilat Oshodi
• Tessy Otasowie
• Diane Ouimet

• Psychiatric/Mental Health Nurse Practitioner in Reynoldsburg, OH
• Providers in Reynoldsburg, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; 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.