Adebayo Kolawole Akinsola, M.D.
Individual provider Active NPI Pediatrics Physician · Chamblee, GA
NPI 1407086879 · NPPES record last updated Sep 20, 2013
Key facts
- NPI
- 1407086879
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 67381 (GA)
- Practice address
- 3807 Clairmont Rd
Chamblee, GA 30341-4911 - Phone
- (917) 370-4485
- NPI assigned
- Jul 20, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121211000539 | GA | Practitioner - Pediatric Medicine | 4486806890 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67381 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grady Memorial Hospital Corporation | Pediatrics | Current |
Accepting new patients |
| Grady Memorial Hospital Corporation | Current |
Accepting new patients |
Locations
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370
3807 Clairmont Rd
Chamblee, GA 30341
Phone (770) 454-1144
Interoperability endpoints
- aakinsola65881@choa.gadirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 67381 | GA | Yes |
Addresses
Primary practice location
3807 Clairmont Rd
Chamblee, GA 30341-4911
Mailing address
403 Caswyck Trce
Johns Creek, GA 30022-2695
Phone (917) 370-4485
Other providers in Chamblee, GA
- 18Wishes LLC
- Abby Maureen Abolt
- Thomas Vincent Adamkiewicz
- Advanced Practice Enterprises PC
- Afc Physicians of Georgia, PC
- All About Care Transport LLC
- Renee Alli
- David Almazan
- Aloha Dental Care PC
- Alphamed Medical Transport LLC
All providers in Chamblee, GA · Pediatrics Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.