Theresa Bamidele, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN218567 Issued in GA

Practice address

1290 Athens St
Gainesville, GA 30507-7000

Phone

(678) 717-4909

NPI assigned

Feb 7, 2017

Last updated

Jul 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Forsyth County Board of Health

  • Public Health or Welfare Agency
  • Cumming, GA
  • NPI 1265597371
  NPD (past)
• Forsyth County Health Department

  • Nursing Care Agency
  • Cumming, GA
  • NPI 1851632046
  NPD (past)

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1215475512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 CANTON RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402002",
            "telephone_number": "770-781-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 ATHENS ST",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305077000",
            "telephone_number": "678-717-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMIDELE",
        "first_name": "THERESA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN218567",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN218567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonia A Bales, CRNA
• Zachary Ryan Balest, M.D.
• Preston Ball, MD
• Andre Lamar Ballard, D.D.S.
• Robert Jay Balotin, M.D.
• Lalitha Bandi, M.D.
• Salankara Bandyopadhyay
• Laura J Banner, NP
• Renee Baptiste
• Lauren Markowski Baquet, MD

• Family Nurse Practitioner in Gainesville, GA
• Providers in Gainesville, 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 Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.