Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Johnthap Obakpolor

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1457215196

Johnthap Obakpolor is a Nurse Practitioner in Minnetonka, Minnesota. Qualified in 2025, 1 year ago. Works from 3 locations. Licensed in Arizona, California and Minnesota.

Years since qualifying
1
Licensed in
AZ, CA, MN
In the registry since
2025
Specialties on file
3
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Practice location Address checks out

12800 Whitewater Dr Ste 100
Minnetonka, MN 55343-9347
Phone: (612) 482-2034
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4527 N 16th St, Phoenix, AZ 85016-5352 — (612) 482-2034
  • 517 S Ivy Ave, Monrovia, CA 91016-2827 — (612) 482-2034

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 13722 (MN)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 95039158 (CA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 225729 (AZ)

Record details

NPI number1457215196
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedDecember 15, 2025
Last updated in NPPESJuly 11, 2026
Certification dateJuly 11, 2026
Mailing address12682 88th Ave N, Maple Grove, MN 55369-3044

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Minnetonka