Active NPI
Olufisayo A Owolabi, NP
- Nurse Practitioner
- Vauxhall, NJ
National Provider Identifier
1689965592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 26NJ01337400
- Practice address
- 123 Carnegie PL
Vauxhall, NJ 07088-1408 - Phone
- (862) 220-1881
- NPI assigned
- Apr 26, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 26NJ01337400 | NJ | Primary |
Addresses
Primary practice location
123 Carnegie PL
Vauxhall, NJ 07088-1408
Mailing address
123 Carnegie PL
Vauxhall, NJ 07088-1408
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ01337400 | NJ | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tranquility Medical Services, LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Union, NJ
- NPI 1891687117
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658534400000",
"number": "1689965592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 CARNEGIE PL",
"city": "VAUXHALL",
"state": "NJ",
"postal_code": "070881408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 CARNEGIE PL",
"city": "VAUXHALL",
"state": "NJ",
"postal_code": "070881408",
"telephone_number": "862-220-1881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OWOLABI",
"first_name": "OLUFISAYO",
"middle_name": "A",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-26",
"last_updated": "2022-07-23",
"certification_date": "2022-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NJ",
"license": "26NJ01337400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vauxhall, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.