Individual provider Active NPI

Angela Agyeiwaa Opuni, MSN, FPMHNP

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1609225291
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018027890 Issued in MO
Practice address
1300 E Bradford Pkwy
Springfield, MO 65804
Phone
(417) 761-5000
Fax
(417) 761-5065
NPI assigned
Jun 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704300922 MI
Family Nurse Practitioner 363LF0000X 2018027890 MO Primary

Addresses

Primary practice location

1300 E Bradford Pkwy
Springfield, MO 65804

Mailing address

1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 761-5000

Other identifiers 2

IdentifierTypeStateIssuer
CAQHOtherMO13848626
420064287MedicaidMO

Other names 1

  • Angela Agyeiwaa Okai Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20181219000788 MO Practitioner - Nurse Practitioner 0840584223 Reassigns benefits to 1 organization

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
Burrell IncGroup PAC ID 4486548625, 217 clinicians

Practice addresses (Care Compare)

1300 E Bradford Pkwy
BLDG a
Springfield, MO 65804-4264
Phone (417) 761-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2018027890MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Burrell, Inc. CurrentSince Dec 5, 2018 Accepting new patients
Burrell, Inc. CurrentSince Dec 5, 2018 Accepting new patients

Locations

1300 E Bradford Pkwy
Bldg A
Springfield, MO 65804
Phone (417) 767-2273

1300 E Bradford Pkwy
Springfield, MO 65804
Phone (417) 269-5400

1300 E Bradford Pkwy
#H
Springfield, MO 65804

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1609225291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65804",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPUNI",
        "first_name": "ANGELA",
        "middle_name": "AGYEIWAA",
        "credential": "MSN, FPMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704300922",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018027890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "13848626",
            "identifier": "CAQH",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420064287",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "OKAI",
            "middle_name": "AGYEIWAA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.