Olufemi Abiodun Taiwo, M.D

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

051606 Issued in GA

Practice address

110 Braxton CT
Fayetteville, GA 30214-1968

Phone

(678) 610-7100

Fax

(678) 610-7111

NPI assigned

Mar 4, 2006

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

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southern Behavioral Healthcare,P.CGroup PAC ID 8628194057, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EDJCCD/Endpoint/EDJCCD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southern Behavioral Healthcare,P.C

  • Child & Adolescent Psychiatry Physician
  • Fayetteville, GA
  • NPI 1598732869
  Medicare reassignment Care Compare group NPD
• Fulton County Mental Health Center

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1437299625
  NPD (past)
• Fulton County Mhddad

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1285700682
  NPD (past)
• Lung Care Specialists PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Fayetteville, GA
  • NPI 1346392339
  NPD (past)

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

{
    "created_epoch": "1141430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1225005598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BRAXTON CT",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141968",
            "telephone_number": "678-610-7100",
            "fax_number": "678-610-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BRAXTON CT",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141968",
            "telephone_number": "678-610-7100",
            "fax_number": "678-610-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAIWO",
        "first_name": "OLUFEMI",
        "middle_name": "ABIODUN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-04",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "GA",
            "license": "051606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000973629B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000973629A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000973629C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Swilling
• Eric Swinson, DMD
• Eve J Sylvain
• Michael John Sylvester, MD
• Synergy Homecare of Fayetteville Ga LLC
• Talk Therapy Home Health Service LLC
• Joanne Talley, RD, LD, CDE
• Suzanne Renee Tambasco, NP
• Tyneshea Marlene Tanner, PHARM.D.
• Tara a Fogle, D.M.D, P.C.

• Child & Adolescent Psychiatry Physician in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Child & Adolescent Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.
• 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.