Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

JOHNTHAP OBAKPOLOR
NPI 1457215196
Nurse Practitioner - Psychiatric/Mental Health in Minnetonka, MN

Active since December 15, 2025PECOS Enrolled
12800 WHITEWATER DR STE 100, MINNETONKA, MN 55343(612) 482-2034 Get Directions Write a Review

NPPES record last updated: July 11, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 11, 2026, Jan 8, 2026, Dec 15, 2025 (3 updates tracked since 2025).

About Johnthap Obakpolor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHNTHAP OBAKPOLOR (NPI 1457215196) is an individual psychiatric/mental health provider in Minnetonka, Minnesota, licensed in Minnesota (13722) and active in the NPI registry since December 2025. The provider is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1457215196
Entity TypeIndividual
Primary Taxonomy363LP0808X
Provider Legal NameJOHNTHAP OBAKPOLOR
Location Address12800 WHITEWATER DR STE 100Minnetonka, MN 55343-9347
Mailing Address12682 88th Ave NMaple Grove, MN 55369-3044
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateDecember 15, 2025
Last NPPES UpdateJuly 11, 20263 updates tracked since enumeration
NPPES CertifiedJuly 11, 2026
NPI 1457215196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses Licensed in MN · 13722 Licensed in CA · 95039158 Licensed in AZ · 225729
12800 WHITEWATER DR STE 100, Minnetonka, MN 55343

Secondary Practice Locations 2

Location 14527 N 16th StPhoenix, AZ 85016-5352 · Phone (612) 482-2034
Location 2517 S Ivy AveMonrovia, CA 91016-2827 · Phone (612) 482-2034

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Johnthap Obakpolor is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365922119
PECOS Enrollment IDI20260219001571
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55343 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
12800 WHITEWATER DR STE 100
MINNETONKA, MN 55343
Psychologist (Clinical)
12800 WHITEWATER DR STE 100
MINNETONKA, MN 55343
Social Worker (Clinical)
12800 WHITEWATER DR STE 100
MINNETONKA, MN 55343
Home Health
12800 WHITEWATER DR STE 100
MINNETONKA, MN 55343
Community Health Worker
12800 WHITEWATER DR STE 100
MINNETONKA, MN 55343
Case Management
12800 WHITEWATER DR STE 100
MINNETONKA, MN 55343
Counselor (Mental Health)
12800 WHITEWATER DR STE 100
MINNETONKA, MN 55343
Clinic/Center (Health Service)
12800 WHITEWATER DR STE 100
MINNETONKA, MN 55343

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Johnthap Obakpolor's NPI number?

The NPI number for Johnthap Obakpolor is 1457215196. It was assigned to this individual provider in the NPPES registry on December 15, 2025.

Where is Johnthap Obakpolor located?

Johnthap Obakpolor practices at 12800 Whitewater Dr Ste 100, Minnetonka, MN 55343. The listed phone number is (612) 482-2034.

What is Johnthap Obakpolor's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Johnthap Obakpolor enrolled in Medicare?

Yes. Johnthap Obakpolor is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Johnthap Obakpolor was last updated on July 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.