Individual provider Active NPI

Afusat Adeyemi

  • Psychiatric/Mental Health Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1093126708
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
C-APN0102132-C-NP Issued in CO
Practice address
602 Green St
Lawrenceville, GA 30046-6054
Phone
(762) 334-3392
Fax
(762) 212-4352
NPI assigned
May 15, 2014
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN202394 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN202394 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN0102132-C-NP CO Primary

Addresses

Primary practice location

602 Green St
Lawrenceville, GA 30046-6054

Mailing address

469 Corbin Oak RDG
Grayson, GA 30017-7866
Phone (770) 557-0041

Other practice location 1

50 Glenlake Pkwy Ste 200
Sandy Springs, GA 30328-3488
Phone (833) 917-2106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WI, MN, DC, CO, AZ, WA, HI8 enrollments
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 8

Enrollment IDStateProvider typePAC IDDetails
I20140613001438 GA Practitioner - Nurse Practitioner 8224252259 Reassigns benefits to 2 organizations
I20240927002037 WI Practitioner - Nurse Practitioner 8224252259 Reassigns benefits to 1 organization
I20241014001920 MN Practitioner - Nurse Practitioner 8224252259 Reassigns benefits to 1 organization
I20250116003825 DC Practitioner - Nurse Practitioner 8224252259 Reassigns benefits to 1 organization
I20250116003928 CO Practitioner - Nurse Practitioner 8224252259 Reassigns benefits to 2 organizations
I20250117001947 AZ Practitioner - Nurse Practitioner 8224252259 Reassigns benefits to 1 organization
I20250117002147 WA Practitioner - Nurse Practitioner 8224252259 Reassigns benefits to 1 organization
I20250117002328 HI Practitioner - Nurse Practitioner 8224252259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

720 S Colorado Blvd
PH North
Denver, CO 80246-1904
Phone (844) 843-7279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
C-APN0102132-C-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rogers Memorial Hospital Incorporated CurrentSince Jul 10, 2024 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Aug 4, 2024 Accepting new patients
Rogers Behavioral Health Practice PC Psychiatric/Mental Health CurrentSince May 1, 2020 Accepting new patients
Rogers Behavioral Health - Georgia Inc CurrentSince May 1, 2020 Accepting new patients
Sondermind Provider Network LLC Psychiatric/Mental Health CurrentSince Aug 1, 2025 Accepting new patients
Twins Caring Hands LLC Psychiatric/Mental Health CurrentSince Oct 30, 2024 Accepting new patients
Rogers Memorial Hospital Incorporated Past Accepting new patients
Rogers Behavioral Health - Wisconsin SC Psychiatric/Mental Health Past Accepting new patients
Rogers Behavioral Health Practice - Colorado PC Psychiatric/Mental Health PastSince Mar 20, 2022 Accepting new patients
Rogers Behavioral Health - Colorado Inc PastSince Mar 6, 2022 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

5445 Dtc Pkwy
Ph 4
Greenwood Village, CO 80111
Phone (720) 571-4874

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

50 Glenlake Pkwy
Ste 200
Sandy Springs, GA 30328
Phone (470) 622-2400

500 Ala Moana Blvd
Ste 7400
Honolulu, HI 96813
Phone (617) 823-6490

6442 City West Pkwy
Ste 200
Eden Prairie, MN 55344
Phone (763) 318-2788

2355 Highway 36 W
Ste 400
Saint Paul, MN 55113
Phone (612) 460-1597

576 Bielenberg Dr
Ste 180
Woodbury, MN 55125
Phone (612) 225-4141

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

4351 W College Ave
Ste 300
Appleton, WI 54914
Phone (844) 258-1072

5 Innovation Ct
Ste 100
Appleton, WI 54914

9916 75th St
Kenosha, WI 53142
Phone (262) 697-3800

406 Science Dr
Ste 110
Madison, WI 53711
Phone (608) 238-4411

34700 Valley Rd
Oconomowoc, WI 53066

1108 S Wildwood Ave
Sheboygan, WI 53081
Phone (844) 258-1072

11101 W Lincoln Ave
West Allis, WI 53227
Phone (414) 203-4500

2424 S 102nd St
West Allis, WI 53227
Phone (414) 373-7474

Networks

  • HI PPO
  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1093126708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 CORBIN OAK RDG",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300177866",
            "telephone_number": "770-557-0041",
            "fax_number": "678-353-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 GREEN ST",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300466054",
            "telephone_number": "762-334-3392",
            "fax_number": "762-212-4352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Glenlake Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Sandy Springs",
            "state": "GA",
            "postal_code": "303283488",
            "country_code": "US",
            "telephone_number": "833-917-2106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADEYEMI",
        "first_name": "AFUSAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-15",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN202394",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN202394",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN0102132-C-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.