Individual provider Active NPI

Rasheedah Adunni Aderoju-Ibidunni

  • Family Nurse Practitioner
  • Douglasville, GA
National Provider Identifier
1184268682
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN251887 Issued in GA
Practice address
12461 Veterans Memorial Hwy
Douglasville, GA 30134-2025
Phone
(404) 395-1742
NPI assigned
Oct 29, 2019
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN251887 GA Primary

Addresses

Primary practice location

12461 Veterans Memorial Hwy
Douglasville, GA 30134-2025

Mailing address

PO Box 490845
Atlanta, GA 30349-0059

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
I20210423000393 GA Practitioner - Nurse Practitioner 7315355765 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1001 Virginia Ave
Hapeville, GA 30354-1328
Phone (404) 537-1636

1550 Kennesaw Due W Rd NW
Kennesaw, GA 30152-4338

2710 Fairburn Rd
Douglasville, GA 30135-2942
Phone (943) 202-8640

4480 N Cooper Lake Rd SE
Smyrna, GA 30082-4623

4480 N Cooper Lake Serd
Smyrna, GA 30082-4623

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

662 Carrollton Villa Rica Hwy
Villa Rica, GA 30180-4969

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN251887GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Jan 19, 2021 Accepting new patients
Wellstreet of Georgia PC CurrentSince May 1, 2023 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients
Apogee Medical Group Georgia Inc CurrentSince Apr 1, 2021 Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

865 N Highland Ave NE
Atlanta, GA 30306
Phone (404) 733-6089

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

1001 Virginia Ave
Hapeville, GA 30354
Phone (404) 500-1675

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000

Organizations & group practices 6

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": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1184268682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490845",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303490059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12461 VETERANS MEMORIAL HWY",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342025",
            "telephone_number": "404-395-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEROJU-IBIDUNNI",
        "first_name": "RASHEEDAH",
        "middle_name": "ADUNNI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN251887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.