Upperhealth Wellness Center LLC

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

Legal business name

UPPERHEALTH WELLNESS CENTER LLC

Practice address

11340 Lakefield Dr Ste 200
Johns Creek, GA 30097-2456

Phone

(678) 895-8405

NPI assigned

Aug 18, 2025

Organization subpart

No

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

Authorized official

Name

Basirat O ShomuyiwaNPI 1730907338

Title

Owner

Phone

(678) 895-8405

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Basirat Oladunni Shomuyiwa

  • Psychiatric/Mental Health Nurse Practitioner
  • Johns Creek, GA
  • NPI 1730907338

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1154208577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11340 LAKEFIELD DR STE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300972456",
            "telephone_number": "678-895-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 LAKEFIELD DR STE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300972456",
            "telephone_number": "678-895-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPERHEALTH WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "SHOMUYIWA",
        "authorized_official_first_name": "BASIRAT",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-895-8405"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Registered Nurse in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Psychiatric/Mental Health Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.