Individual provider Active NPI

Celestina Okundaye, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1801657523
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023206764 Issued in MD
Practice address
547 Riverside Drive
Salisbury, MD 21801
Phone
(443) 355-7517
NPI assigned
Jan 19, 2024
Last updated
Nov 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023206764 MD Primary

Addresses

Primary practice location

547 Riverside Drive
Salisbury, MD 21801

Mailing address

547 Riverside Drive
Salisbury, MD 21801
Phone (240) 688-6656

Other identifiers 1

IdentifierTypeStateIssuer
R165547OtherMDMARYLAND BOARD OF NURSING (RN LICENSE)

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

State licenses

LicenseStateTypeSpecialty
2023206764MDMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1801657523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 RIVERSIDE DRIVE",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21801",
            "telephone_number": "240-688-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 RIVERSIDE DRIVE",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21801",
            "telephone_number": "443-355-7517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUNDAYE",
        "first_name": "CELESTINA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-11-27",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "2023206764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BOARD OF NURSING (RN LICENSE)",
            "identifier": "R165547",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.