Individual provider Active NPI

Folashade Dada, AGACNP

  • Acute Care Nurse Practitioner
  • Gainesville, GA
National Provider Identifier
1043067630
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN269797 Issued in GA
Practice address
743 Spring St NE
Gainesville, GA 30501-3715
Phone
(770) 534-2020
NPI assigned
May 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN269797 GA Primary

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3715

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241030001037 GA Practitioner - Nurse Practitioner 1658804687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Heart Institute LLCGroup PAC ID 4183848062, 127 clinicians

Practice addresses (Care Compare)

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 534-2020

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN269797GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Heart Center Current Accepting new patients
Georgia Heart Institute LLC CurrentSince Sep 20, 2024 Accepting new patients

Locations

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

200 S Enota Dr NE
Ste 200
Gainesville, GA 30501
Phone (770) 534-0991

Organizations & group practices 2

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": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1043067630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420",
            "fax_number": "678-353-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-534-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADA",
        "first_name": "FOLASHADE",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN269797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.