Organization Active NPI

Ognomy Ga LLC

  • Sleep Medicine (Internal Medicine) Physician
  • Marietta, GA
National Provider Identifier
1043817992
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
Legal business name
OGNOMY GA LLC
Practice address
3750 Palladian Village Dr Ste 110
Marietta, GA 30066-8202
Phone
(678) 878-2555
Fax
(404) 900-9055
NPI assigned
Oct 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Morohunfolu Akinnusi, MD
Title
Organizer
Phone
(678) 878-2555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X Primary

Addresses

Primary practice location

3750 Palladian Village Dr Ste 110
Marietta, GA 30066-8202

Mailing address

640 Ellicott St Ste 101
Buffalo, NY 14203-1252
Phone (877) 664-6669

Other practice location 1

8101 College Blvd Ste 100
Overland Park, KS 66210-2671
Phone (877) 644-6669

Other practice location 2

400 Shadowline Dr Ste 202
Boone, NC 28607-4960
Phone (877) 644-6669

Other practice location 3

9620 NE Tanasbourne Dr Ste 300
Hillsboro, OR 97124-7844
Phone (877) 644-6669

Other practice location 4

725 Kingsland Ave Ste 100
Saint Louis, MO 63130-3187
Phone (877) 644-6669

Other practice location 5

1501 Belle Isle Ave Ste 110
Mount Pleasant, SC 29464-8379
Phone (877) 644-6669

Other practice location 6

711 E Ascension St
Gonzales, LA 70737-3028
Phone (877) 644-6669

Other practice location 7

720 Seneca St Ste 107
Seattle, WA 98101-3265
Phone (877) 644-6669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC, LA, OR, SC, WA, MO, MS8 enrollments

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
O20210519001863 GA Part B Supplier - Clinic/Group Practice 1254730534 Receives reassigned benefits from 6 practitioners
Practice locations: Marietta, GA
O20230508000767 NC Part B Supplier - Clinic/Group Practice 1254730534 Receives reassigned benefits from 5 practitioners
Practice locations: Boone, NC
O20230509001311 LA Part B Supplier - Clinic/Group Practice 1254730534 Receives reassigned benefits from 2 practitioners
Practice locations: Gonzales, LA
O20230523001504 OR Part B Supplier - Clinic/Group Practice 1254730534 Receives reassigned benefits from 3 practitioners
Practice locations: Hillsboro, OR
O20230523002201 SC Part B Supplier - Clinic/Group Practice 1254730534 Receives reassigned benefits from 2 practitioners
Practice locations: Mount Pleasant, SC
O20230607000546 WA Part B Supplier - Clinic/Group Practice 1254730534 Receives reassigned benefits from 2 practitioners
Practice locations: Seattle, WA
O20230922001552 MO Part B Supplier - Clinic/Group Practice 1254730534 Receives reassigned benefits from 3 practitioners
Practice locations: Saint Louis, MO
O20231218000788 MS Part B Supplier - Clinic/Group Practice 1254730534 Receives reassigned benefits from 2 practitioners
Practice locations: McComb, MS

National Provider Directory

National Provider Directory

Locations

3750 Palladian Village Dr
Ste 120
Marietta, GA 30066

3750 Palladian Village Dr
Ste 110120
Marietta, GA 30066
Phone (678) 265-8361

1102A Delaware Ave
McComb, MS 39648

1275 Blowing Rock Rd
Boone, NC 28607

400 Shadowline Dr
Ste 202
Boone, NC 28607
Phone (828) 262-0600

1501 Belle Isle Ave
Ste 11
Mount Pleasant, SC 29464

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1043817992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 ELLICOTT ST STE 101",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031252",
            "telephone_number": "877-664-6669",
            "fax_number": "716-325-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 PALLADIAN VILLAGE DR STE 110",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300668202",
            "telephone_number": "678-878-2555",
            "fax_number": "404-900-9055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8101 College Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662102671",
            "country_code": "US",
            "telephone_number": "877-644-6669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Shadowline Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Boone",
            "state": "NC",
            "postal_code": "286074960",
            "country_code": "US",
            "telephone_number": "877-644-6669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9620 NE Tanasbourne Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971247844",
            "country_code": "US",
            "telephone_number": "877-644-6669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Kingsland Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631303187",
            "country_code": "US",
            "telephone_number": "877-644-6669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 Belle Isle Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294648379",
            "country_code": "US",
            "telephone_number": "877-644-6669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "711 E Ascension St",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "LA",
            "postal_code": "707373028",
            "country_code": "US",
            "telephone_number": "877-644-6669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "720 Seneca St Ste 107",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981013265",
            "country_code": "US",
            "telephone_number": "877-644-6669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OGNOMY GA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "AKINNUSI",
        "authorized_official_first_name": "MOROHUNFOLU",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "678-878-2555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.