Individual provider Active NPI

Chikodi S. Olayinka

  • Family Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1396550976
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F08240070 Issued in GA
Practice address
403 Easley Dr
Lawrenceville, GA 30045-3567
Phone
(404) 488-7654
NPI assigned
Feb 11, 2025
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F08240070 GA Primary

Addresses

Primary practice location

403 Easley Dr
Lawrenceville, GA 30045-3567

Mailing address

403 Easley Dr
Lawrenceville, GA 30045-3567
Phone (404) 667-6762

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250225001523 GA Practitioner - Nurse Practitioner 4981124641

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2620 Elm Hill Pike
Nashville, TN 37214-3108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F08240070GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TLC of Georgia LLC Family CurrentSince Mar 10, 2025 Accepting new patients
Ltoa LLC Family PastSince Feb 23, 2025 Accepting new patients

Locations

505 Dacula Rd
Dacula, GA 30019
Phone (678) 407-8740

455 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

1685 Old Pendergrass Rd
Jefferson, GA 30549
Phone (706) 387-7620

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

Interoperability endpoints

  • Direct secure messaging: chikodi.olayinka@krogerhealth.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1396550976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 EASLEY DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453567",
            "telephone_number": "404-667-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 EASLEY DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453567",
            "telephone_number": "404-488-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAYINKA",
        "first_name": "CHIKODI",
        "middle_name": "S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F08240070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.