Individual provider Active NPI

Oluwabukola Naomi Famakinwa, DO

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1508430943
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
100047 Issued in GA
Practice address
3699 Cascade Rd SW Ste B2
Atlanta, GA 30331-2163
Phone
(404) 691-7006
NPI assigned
May 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL83484 SC
Family Medicine Physician 207Q00000X 100047 GA Primary

Addresses

Primary practice location

3699 Cascade Rd SW Ste B2
Atlanta, GA 30331-2163

Mailing address

1485 Gunnison Cir Apt 11
Sumter, SC 29150-2044

Other practice location 1

Tandem Health Family Medicine
1278 North Lafayette Drive
Sumter, SC 29150
Phone (803) 774-4500

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801003352 GA Practitioner - Family Practice 5294139655 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

3699 Cascade Rd SW
Suite B2
Atlanta, GA 30331-2163
Phone (404) 691-7006

Hospital & facility affiliations

  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
100047GAMDFamily Medicine Physician
LL83484SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Professional Services, LLC Family Medicine CurrentSince Feb 10, 2026 Accepting new patients
Piedmont Medical Care Corporation Family Medicine CurrentSince Aug 5, 2024 Accepting new patients
Piedmont Providers LLC Past Accepting new patients

Locations

3699 Cascade Rd SW
Ste B2
Atlanta, GA 30331
Phone (404) 367-3350

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

1855 Hudson Bridge Rd
Stockbridge, GA 30281
Phone (678) 565-0648

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1508430943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 GUNNISON CIR APT 11",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3699 CASCADE RD SW STE B2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312163",
            "telephone_number": "404-691-7006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Tandem Health Family Medicine",
            "address_2": "1278 North Lafayette Drive",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "29150",
            "country_code": "US",
            "telephone_number": "803-774-4500",
            "fax_number": "803-774-4627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAMAKINWA",
        "first_name": "OLUWABUKOLA",
        "middle_name": "NAOMI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL83484",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "100047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.