Active NPI
Adetutu Mojisola Sandra Ogunleye, CRNM
- Advanced Practice Midwife
- Fayetteville, NC
National Provider Identifier
1720528342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 925
- Practice address
- 3616 Cape Center Dr
Fayetteville, NC 28304-4456 - Phone
- (910) 779-0780
- NPI assigned
- Mar 1, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 5021772 | NC | |
| Advanced Practice Midwife | 367A00000X | 925 | NM | Primary |
| Adult Health Nurse Practitioner | 363LA2200X | 26NJ00710400 | NJ |
Addresses
Primary practice location
3616 Cape Center Dr
Fayetteville, NC 28304-4456
Mailing address
3616 Cape Center Dr
Fayetteville, NC 28304-4456
Phone (910) 779-0780
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119591300 | Medicaid | MD | |
| 0696532 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, NC, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Certified Nurse Midwife (CNM)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
PO Box
Suite 40
San Fidel, NM 87049
PO Box
Suite 40
San Fidel, NM 87049-0040
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5021772 | NC | MD | Adult Health Nurse Practitioner |
| 925 | NM | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Project H.O.P.E., Inc. | Current | Accepting new patients | |
| Divine Family Practice and Urgent Care, PLLC | Current | Accepting new patients | |
| The Cooper Health System | Past | Accepting new patients | |
| Kennedy University Hospital Inc. | Past | Accepting new patients | |
| Virtua Our Lady of Lourdes Hospital Inc | Past | Accepting new patients |
Locations
526 Sandhurst Dr
Fayetteville, NC 28304
Phone (910) 900-8294
3616 Cape Center Dr
Fayetteville, NC 28304
Phone (910) 779-0780
Organizations & group practices 6
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.
-
- Urgent Care Clinic/Center
- Fayetteville, NC
- NPI 1477197168
-
- Federally Qualified Health Center (FQHC)
- Camden, NJ
- NPI 1891969218
-
- General Acute Care Hospital
- Stratford, NJ
- NPI 1386746592
-
- General Acute Care Hospital
- Camden, NJ
- NPI 1568442309
-
- General Acute Care Hospital
- Camden, NJ
- NPI 1235134024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772582400000",
"number": "1720528342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3616 CAPE CENTER DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283044456",
"telephone_number": "910-779-0780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3616 CAPE CENTER DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283044456",
"telephone_number": "910-779-0780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OGUNLEYE",
"first_name": "ADETUTU MOJISOLA",
"middle_name": "SANDRA",
"name_prefix": "Ms.",
"credential": "CRNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-01",
"last_updated": "2026-03-04",
"certification_date": "2026-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NC",
"license": "5021772",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "NM",
"license": "925",
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NJ",
"license": "26NJ00710400",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119591300",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0696532",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.