Individual provider Active NPI

Oladipupo Ayodele Dada

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1376227413
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP031717T Issued in TX
Practice address
1100 Circle 75 Pkwy SE Ste 1400
Atlanta, GA 30339-3067
Phone
(850) 622-0842
NPI assigned
Jun 9, 2023
Last updated
Oct 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X PT016859 GA
Physical Therapist 225100000X CP031717T TX Primary

Addresses

Primary practice location

1100 Circle 75 Pkwy SE Ste 1400
Atlanta, GA 30339-3067

Mailing address

30 Meadow Valley CT
Midland, GA 31820-4393
Phone (719) 310-8283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231212001670 GA Practitioner - Physical Therapist in Private Practice 7810346186 Reassigns benefits to 2 organizations
I20240729001288 TX Practitioner - Physical Therapist in Private Practice 7810346186 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1683 State Hwy 46 W
Suite 215
New Braunfels, TX 78132-4793
Phone (830) 302-2960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP031717TTXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Texas Limited Partnership CurrentSince Dec 31, 2024 Accepting new patients
Theraworks Inc Physical Therapist CurrentSince Dec 31, 2024 Accepting new patients
Georgia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Dec 6, 2023 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Jan 1, 2024 Accepting new patients
Baylor College of Medicine CurrentSince Jul 16, 2024 Accepting new patients
Physiotherapy Associates Inc CurrentSince Dec 31, 2024 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Jan 1, 2024 Accepting new patients
Select Physical Therapy Texas Limited Partnership Physical Therapist CurrentSince Dec 31, 2024 Accepting new patients
Texas Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jul 16, 2024 Accepting new patients
Theraworks Inc Physical Therapist Current Accepting new patients
Baylor College of Medicine CurrentSince Jul 16, 2024 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Physiotherapy Associates Inc Physical Therapist CurrentSince Dec 31, 2024 Accepting new patients
Select Physical Therapy Texas Limited Partnership Physical Therapist Past Accepting new patients

Locations

21 Ortho Ln
Atlanta, GA 30329
Phone (404) 778-2516

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

14700 FM 2100 Rd
Ste 4
Crosby, TX 77532
Phone (281) 328-8346

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

7200 Cambridge St
Fl 6
Houston, TX 77030
Phone (713) 798-2545

5514 Atascocita Rd
Humble, TX 77346
Phone (281) 441-5371

605 Rockmead Dr
Ste 200
Kingwood, TX 77339
Phone (281) 348-9588

1683 State Highway 46 W
Ste 215
New Braunfels, TX 78132
Phone (830) 302-2960

180 State St
Ste 225
Southlake, TX 76092
Phone (682) 429-7066

711 W Bay Area Blvd
Ste 608
Webster, TX 77598
Phone (281) 338-1273

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1376227413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MEADOW VALLEY CT",
            "city": "MIDLAND",
            "state": "GA",
            "postal_code": "318204393",
            "telephone_number": "719-310-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CIRCLE 75 PKWY SE STE 1400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393067",
            "telephone_number": "850-622-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADA",
        "first_name": "OLADIPUPO",
        "middle_name": "AYODELE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-09",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016859",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "CP031717T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.