Individual provider Active NPI

Adebola Oyekoya

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1013273564
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME121470 Issued in FL
Practice address
4651 Roswell Rd Ste D308
Atlanta, GA 30342-3055
Phone
(404) 947-4842
Fax
(404) 947-8244
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X ME121470 FL Primary

Addresses

Primary practice location

4651 Roswell Rd Ste D308
Atlanta, GA 30342-3055

Mailing address

4651 Roswell Rd Ste D308
Atlanta, GA 30342-3055
Phone (404) 947-4842

Other practice location 1

144 South Ave SE
Marietta, GA 30060-2377
Phone (404) 947-4842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161003001865 GA Practitioner - Family Practice 8820275225 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4651 Roswell Rd
Suite D308
Atlanta, GA 30342-3055
Phone (404) 445-0551

Hospital & facility affiliations

  • Marietta Center for Nursing and Healing Nursing home, Marietta, GA, CCN 115206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME121470FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Aug 1, 2016 Accepting new patients
Marietta Ga Opco LLC Past Accepting new patients

Locations

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

Networks

  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • AL HMO
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • AL HMO D-SNP

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHFDCD/Endpoint/AHFDCD

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1013273564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 ROSWELL RD STE D308",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423055",
            "telephone_number": "404-947-4842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 ROSWELL RD STE D308",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423055",
            "telephone_number": "404-947-4842",
            "fax_number": "404-947-8244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 South Ave SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300602377",
            "country_code": "US",
            "telephone_number": "404-947-4842",
            "fax_number": "404-947-8244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OYEKOYA",
        "first_name": "ADEBOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME121470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.