RESONANCEBRIDGE PSYCHIATRY & WELLNESS LLC
NPI 1639034770
Nurse Practitioner - Psychiatric/Mental Health in Maple Grove, MN
About Resonancebridge Psychiatry & Wellness Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RESONANCEBRIDGE PSYCHIATRY & WELLNESS LLC (NPI 1639034770) is a healthcare organization registered as a psychiatric/mental health in Maple Grove, Minnesota and active in the NPI registry since December 2025. The organization maintains a secondary practice location in Lehi and lists Johnthap Obakpolor, Pmhnp, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Resonancebridge Psychiatry & Wellness Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Resonancebridge Psychiatry & Wellness LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Resonancebridge Psychiatry & Wellness LLC's NPI number?
The NPI number for Resonancebridge Psychiatry & Wellness LLC is 1639034770. It was assigned to this organization in the NPPES registry on December 20, 2025.
Where is Resonancebridge Psychiatry & Wellness LLC located?
Resonancebridge Psychiatry & Wellness LLC is located at 12682 88th Ave N, Maple Grove, MN 55369. The listed phone number is (612) 482-2034.
What is Resonancebridge Psychiatry & Wellness LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Resonancebridge Psychiatry & Wellness LLC enrolled in Medicare?
Yes. Resonancebridge Psychiatry & Wellness LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Resonancebridge Psychiatry & Wellness LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Resonancebridge Psychiatry & Wellness LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Resonancebridge Psychiatry & Wellness LLC was last updated on September 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.
# Resonancebridge Psychiatry & Wellness Llc · NPI 1639034770
Psychiatric/Mental Health organization in Maple Grove, Minnesota. Organization record, active in the CMS NPPES registry since December 20, 2025.
## Identity
- **NPI:** 1639034770 (Entity type: Organization)
- **Enumerated:** December 20, 2025
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Johnthap Obakpolor, PMHNP
## Practice location
- **Address:** 12682 88TH AVE N, Maple Grove, MN 55369-3044
- **Phone:** (612) 482-2034
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 1, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1639034770) · Data from the CMS NPPES public registry.