Individual provider Active NPI

Adetutu Mojisola Sandra Ogunleye, CRNM

  • Advanced Practice Midwife
  • Fayetteville, NC
National Provider Identifier
1720528342
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
925 Issued in NM
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

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
119591300MedicaidMD
0696532MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NC, TX3 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
I20191107001102 NJ Practitioner - Nurse Practitioner 4688006919 Reassigns benefits to 1 organization
I20250731004019 NC Practitioner - Nurse Practitioner 4688006919 Reassigns benefits to 1 organization
I20260615003171 TX Practitioner - Certified Nurse Midwife (CNM) 4688006919 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
5021772NCMDAdult Health Nurse Practitioner
925NMMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Project H.O.P.E., Inc. CurrentSince Apr 11, 2022 Accepting new patients
Divine Family Practice and Urgent Care, PLLC CurrentSince Jun 1, 2025 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.

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

Verify at the official NPI Registry.