Shittu Family Practice,LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

SHITTU FAMILY PRACTICE,LLC

Practice address

213 Banks Rd
Fayetteville, GA 30214

Phone

(770) 629-1917

NPI assigned

Sep 22, 2020

Organization subpart

No

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

Authorized official

Name

Tawa Sitou, NPNPI 1356979363

Title

FNP

Phone

(770) 629-1917

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Tawa Kalytou Sitou, FNP

  • Family Nurse Practitioner
  • Stockbridge, GA
  • NPI 1356979363

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1194331439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 BANKS STA",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147505",
            "telephone_number": "770-629-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 BANKS RD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-629-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHITTU FAMILY PRACTICE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-22",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "SITOU",
        "authorized_official_first_name": "TAWA",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "770-629-1917",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Hampton",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11679 Bruce Dr",
            "city": "Hampton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302284008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fayetteville",
            "affiliation": "N",
            "endpointDescription": "CLINIC",
            "address_1": "213 Banks Sta",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302147505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anne Marie Sheridan
• Daryl Sherrod, M.D.
• Taiwo Sheyin, MD
• Emily Shiflett
• Shirley Home Away From Home
• Myra Shivers
• Ameera Waseem Siddiqi, MD
• Howard J Silk, MD
• Silver Cypress Group, LLC
• Karmon M Simmons, LMT

• Family Nurse Practitioner in Fayetteville, GA
• Providers in Fayetteville, 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 May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.