Individual provider Active NPI

Olufunmilayo Kwentua

  • Psychiatric/Mental Health Nurse Practitioner
  • Gonzales, LA
National Provider Identifier
1669167672
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
227572 Issued in LA
Practice address
14219 Calice St
Gonzales, LA 70737-5972
Phone
(225) 803-7593
NPI assigned
Apr 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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 227572 LA Primary

Addresses

Primary practice location

14219 Calice St
Gonzales, LA 70737-5972

Mailing address

14219 Calice St
Gonzales, LA 70737-5972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, LA, IA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20231211003265 AZ Practitioner - Nurse Practitioner 3476902891 Reassigns benefits to 1 organization
I20240305002333 LA Practitioner - Nurse Practitioner 3476902891 Reassigns benefits to 5 organizations
I20240418002135 IA Practitioner - Nurse Practitioner 3476902891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Area Human Services DistrictGroup PAC ID 2769450733, shared by 3 NPIs, 30 clinicians

Practice addresses (Care Compare)

2751 Wooddale Blvd
Baton Rouge, LA 70805-7567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Area Human Services District CurrentSince Nov 11, 2024 Accepting new patients
Capital Area Human Services District Current Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Nov 6, 2024 Accepting new patients
Victory Health Solution LLC Psychiatric/Mental Health CurrentSince Mar 24, 2024 Accepting new patients
Capital Area Human Services District CurrentSince Nov 11, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients
Capital Area Human Services District CurrentSince Nov 11, 2024 Accepting new patients
Capital Area Human Services District CurrentSince Nov 11, 2024 Accepting new patients
Hope Therapy & Consulting Services, Inc Past Accepting new patients

Locations

699 Walnut St
Ste 4
Des Moines, IA 50309
Phone (515) 278-9920

7855 Howell Blvd
Ste 200
Baton Rouge, LA 70807
Phone (225) 359-9315

2751 Wooddale Blvd
Ste A
Baton Rouge, LA 70805
Phone (225) 925-1906

1056 E Worthy St
Ste B
Gonzales, LA 70737
Phone (225) 621-5770

1 Galleria Blvd
Ste 1900
Metairie, LA 70001
Phone (504) 332-8698

Organizations & group practices 9

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": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1669167672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14219 CALICE ST",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707375972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14219 CALICE ST",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707375972",
            "telephone_number": "225-803-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWENTUA",
        "first_name": "OLUFUNMILAYO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "227572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

Verify at the official NPI Registry.