Adefunke Rachel Odujole

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

8170 Issued in MN

Practice address

9698 Hames Ave S
Cottage Grove, MN 55016-3871

Phone

(651) 434-5748

NPI assigned

May 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD
• Pathway Home Healthcare LLC

  • Administrator Registered Nurse
  • Cottage Grove, MN
  • NPI 1790636199
  NPD Authorized official

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1750964094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9698 HAMES AVE S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550163871",
            "telephone_number": "651-434-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9698 HAMES AVE S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550163871",
            "telephone_number": "651-434-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUJOLE",
        "first_name": "ADEFUNKE",
        "middle_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Edward O'Connor, RPH
• Oasis Chiropractic PA
• Lisa Marie Ocasio
• Oceanic Medical Management LLC
• Babara Jean Odman, MASSAGE THERAPIST
• Oyeyemi Elizabeth Odujole
• Oehler Chiropractic P.L.L.C.
• Dustin Lee Oehler, D.C.
• Kenneth Nworah Okafor, PHARMD
• Ebosetale Odiaogbe Okoruwa, DDS

• Psychiatric/Mental Health Nurse Practitioner in Cottage Grove, MN
• Providers in Cottage Grove, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.

Verify at the official NPI Registry.