Adekunle Olatunde, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

211997 Issued in GA

Practice address

2219 Clayton RDG
Lithonia, GA 30058-2608

Phone

(404) 424-2091

NPI assigned

Jun 29, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1174018386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 CLAYTON RDG",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300582608",
            "telephone_number": "404-424-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 CLAYTON RDG",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300582608",
            "telephone_number": "404-424-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLATUNDE",
        "first_name": "ADEKUNLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-29",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "211997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.