Individual provider Active NPI

Omobolanle Opeoluwa Olagoke, FNP-C, PMHNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Apex, NC
National Provider Identifier
1902350770
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5008848 Issued in NC
Practice address
3675 Green Level West Rd Ste 209
Apex, NC 27523-7611
Phone
(919) 267-4659
Fax
(919) 799-5134
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 5008848 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5008848 NC Primary

Addresses

Primary practice location

3675 Green Level West Rd Ste 209
Apex, NC 27523-7611

Mailing address

3675 Green Level West Rd Ste 209
Apex, NC 27523-7611
Phone (617) 515-3540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161115002068 NC Practitioner - Nurse Practitioner 4688953698 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Wellness Center LLC Multi-Specialty CurrentSince Apr 3, 2025 Accepting new patients
Signify Health Medical Associates, PLLC Multi-Specialty CurrentSince May 31, 2022 Accepting new patients

Locations

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

160 Mine Lake Ct
#200
Raleigh, NC 27615
Phone (404) 805-4288

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1902350770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 GREEN LEVEL WEST RD STE 209",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275237611",
            "telephone_number": "617-515-3540",
            "fax_number": "919-799-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 GREEN LEVEL WEST RD STE 209",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275237611",
            "telephone_number": "919-267-4659",
            "fax_number": "919-799-5134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAGOKE",
        "first_name": "OMOBOLANLE",
        "middle_name": "OPEOLUWA",
        "credential": "FNP-C, PMHNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008848",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5008848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

Verify at the official NPI Registry.