Resonancebridge Psychiatry & Wellness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

RESONANCEBRIDGE PSYCHIATRY & WELLNESS LLC

Practice address

12682 88TH Ave N
Maple Grove, MN 55369-3044

Phone

(612) 482-2034

NPI assigned

Dec 20, 2025

Organization subpart

No

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

Authorized official

Name

Johnthap Obakpolor, APRNNPI 1457215196

Title

Pmhnp

Phone

(612) 482-2034

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Johnthap Obakpolor

  • Psychiatric/Mental Health Nurse Practitioner
  • Minnetonka, MN
  • NPI 1457215196
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1766188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1639034770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 WHITEWATER DR STE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12682 88TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553693044",
            "telephone_number": "612-482-2034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 W Blue Grass Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lehi",
            "state": "UT",
            "postal_code": "840484190",
            "country_code": "US",
            "telephone_number": "612-482-2034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RESONANCEBRIDGE PSYCHIATRY & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-20",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A",
        "authorized_official_last_name": "OBAKPOLOR",
        "authorized_official_first_name": "JOHNTHAP",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "612-482-2034",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

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