Adeyemisi O Akinnawo

Key facts

NPI

1225860976

Entity type

Individual (NPI type 1)

Primary specialty

Adult Health Nurse Practitioner 363LA2200X

License

RN244529 (GA)

Practice address

1670 Clairmont Rd
Decatur, GA 30033-4004

Phone

(201) 898-9693

NPI assigned

Aug 20, 2024

Sex

Female

Sole proprietor

Yes

Organizations & group practices 2

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.

• Pulse Primary Care of Texas PLLC Internal Medicine Physician · Fort Worth, TX · NPI 1033006986
  Medicare reassignment NPD TX
• Watauga Family Practice PA Family Medicine Physician · Fort Worth, TX · NPI 1740369073
  NPD (past)

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 1, 2024.

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1225860976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334004",
            "telephone_number": "470-249-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334004",
            "telephone_number": "201-898-9693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2418 Warrington Pl",
            "address_purpose": "LOCATION",
            "city": "Venus",
            "state": "TX",
            "postal_code": "760843153",
            "country_code": "US",
            "telephone_number": "201-898-9693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKINNAWO",
        "first_name": "ADEYEMISI",
        "middle_name": "O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN244529",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN244529",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN244529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shari Aizenman, LMT
• Wanda Aker, RN
• Scott J Akin, M.D.
• Olubusola Oluyemi Akinbote, PHARM.D.
• Adebowale O Akintayo, MD, MPH
• Adebayo A Akintobi, M.D., M.P.H.
• Makungu Mshairi Akinyela, LMFT
• Akoma Consulting Inc
• Akoma Counseling & Consulting, Inc

All providers in Decatur, GA · Adult Health Nurse Practitioner in Georgia