Organization Active NPI

Delomwood Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1750107348
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
DELOMWOOD PSYCHIATRY PLLC
Practice address
1341 W Mockingbird LN Ste 600W
Dallas, TX 75247-6904
Phone
(214) 284-5501
NPI assigned
Nov 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Authorized official

Name
Olanrewaju Peter OlayemiNPI 1295394450
Title
Ceo
Phone
(214) 284-5501

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1341 W Mockingbird LN Ste 600W
Dallas, TX 75247-6904

Mailing address

1341 W Mockingbird LN Ste 600W
Dallas, TX 75247-6904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241205003792 TX Part B Supplier - Clinic/Group Practice 2466988076 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Locations

1341 W Mockingbird Ln
Ste 600W
Dallas, TX 75247
Phone (303) 748-5781

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1750107348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 W MOCKINGBIRD LN STE 600W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752476904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 W MOCKINGBIRD LN STE 600W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752476904",
            "telephone_number": "214-284-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELOMWOOD PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "OLAYEMI",
        "authorized_official_first_name": "OLANREWAJU",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-284-5501"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.