Active NPI
Hannah Funmilayo Lawal Adeniji
- Nurse Practitioner
- Grovetown, GA
National Provider Identifier
1245717552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN221553
- Practice address
- 479 Sebastian Dr
Grovetown, GA 30813-4912 - Phone
- (705) 373-0094
- NPI assigned
- Jul 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN221553 | GA | Primary |
Addresses
Primary practice location
479 Sebastian Dr
Grovetown, GA 30813-4912
Mailing address
1 Freedom Way
Augusta, GA 30904-6258
Phone (706) 733-0188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190206002715 | GA | Order and Referring Only - Nurse Practitioner | 0941548580 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532044800000",
"number": "1245717552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FREEDOM WAY",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309046258",
"telephone_number": "706-733-0188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "479 SEBASTIAN DR",
"city": "GROVETOWN",
"state": "GA",
"postal_code": "308134912",
"telephone_number": "705-373-0094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWAL ADENIJI",
"first_name": "HANNAH",
"middle_name": "FUNMILAYO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-20",
"last_updated": "2018-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN221553",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grovetown, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.