Individual provider Active NPI

Olaleye Augustine Olowookere, RN

  • Registered Nurse
  • Mansfield, TX
National Provider Identifier
1821454935
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
814598 Issued in TX
Practice address
706 Cypresswood LN
Mansfield, TX 76063-7294
Phone
(312) 451-6917
Fax
(214) 945-1009
NPI assigned
Jan 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 814598 TX Primary

Addresses

Primary practice location

706 Cypresswood LN
Mansfield, TX 76063-7294

Mailing address

2704 Waterway Dr
Grand Prairie, TX 75054-7251
Phone (312) 451-6917

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
814598TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Christabel, LLC Current Accepting new patients
Cedarbloom, LLC Current Accepting new patients
Cedarbloom, Limited Liability Company CurrentSince Feb 9, 2025 Accepting new patients

Organizations & group practices 3

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": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1821454935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 WATERWAY DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750547251",
            "telephone_number": "312-451-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 CYPRESSWOOD LN",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637294",
            "telephone_number": "312-451-6917",
            "fax_number": "214-945-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOWOOKERE",
        "first_name": "OLALEYE",
        "middle_name": "AUGUSTINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-05",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "814598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.