Individual provider Active NPI

Oyindamola Olubukola Ajayi

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1922979400
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
258520 Issued in AZ
Practice address
15715 S 46TH St Ste 100
Phoenix, AZ 85048-0439
Phone
(480) 961-2365
Fax
(480) 961-2382
NPI assigned
Sep 16, 2025
Last updated
May 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2026

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 258520 AZ Primary

Addresses

Primary practice location

15715 S 46TH St Ste 100
Phoenix, AZ 85048-0439

Mailing address

4505 E Chandler Blvd Ste 200
Phoenix, AZ 85048-7688
Phone (480) 961-2365

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260520002172 AZ Practitioner - Nurse Practitioner 9133698012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2155 E Gemini PL
Chandler, AZ 85249-2116

4505 E Chandler Blvd
Suite 200
Phoenix, AZ 85048-7688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
258520AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Neurology P C Single Specialty CurrentSince Apr 16, 2026 Accepting new patients

Locations

15715 S 46th St
Ste 100
Phoenix, AZ 85048

4505 E Chandler Blvd
Ste 200
Phoenix, AZ 85048

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1757980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1922979400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 E CHANDLER BLVD STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487688",
            "telephone_number": "480-961-2365",
            "fax_number": "480-961-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15715 S 46TH ST STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480439",
            "telephone_number": "480-961-2365",
            "fax_number": "480-961-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAYI",
        "first_name": "OYINDAMOLA",
        "middle_name": "OLUBUKOLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-16",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "258520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.