Individual provider Active NPI

Oyefunke Ogunnaike, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Union, NJ
National Provider Identifier
1720798846
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01372500 Issued in NJ
Practice address
540 North Ave Ste 4
Union, NJ 07083-7149
Phone
(862) 754-9834
NPI assigned
Nov 29, 2022
Last updated
Nov 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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 26NJ01372500 NJ Primary

Addresses

Primary practice location

540 North Ave Ste 4
Union, NJ 07083-7149

Mailing address

540 North Ave Ste 4
Union, NJ 07083-7149
Phone (862) 754-9834

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

LicenseStateTypeSpecialty
26NJ01372500NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Mental Health Services LLC Psychiatric/Mental Health CurrentSince Dec 6, 2022 Accepting new patients
Family Mental Health Services LLC Independent Clinic CurrentSince Dec 6, 2022 Accepting new patients

Locations

540 North Ave
Ste 4
Union, NJ 07083
Phone (908) 588-2445

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1720798846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 NORTH AVE STE 4",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837149",
            "telephone_number": "862-754-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 NORTH AVE STE 4",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837149",
            "telephone_number": "862-754-9834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNNAIKE",
        "first_name": "OYEFUNKE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-29",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01372500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.

Verify at the official NPI Registry.