Individual provider Active NPI

Anthonia D Adewole, M.D

  • Colon & Rectal Surgery Physician
  • Prosper, TX
National Provider Identifier
1598907925
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
T9330 Issued in TX
Practice address
2120 Prairie Dr Ste 502
Prosper, TX 75078-3820
Phone
(469) 447-4893
Fax
(469) 447-4925
NPI assigned
Mar 31, 2009
Last updated
Jul 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X SSN/ITIN DELETED CT
Colon & Rectal Surgery Physician 208C00000X 073405 GA
Colon & Rectal Surgery Physician 208C00000X T9330 TX Primary

Addresses

Primary practice location

2120 Prairie Dr Ste 502
Prosper, TX 75078-3820

Mailing address

2120 Prairie Dr Ste 502
Prosper, TX 75078-3820
Phone (469) 447-4893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161012002723 GA Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 5991093692 Reassigns benefits to 1 organization
I20221213001916 TX Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 5991093692 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2120 Prairie Dr
Suite 502
Prosper, TX 75078-3820
Phone (469) 447-4893

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SSN/ITIN DELETEDCTMDSurgery Physician
073405GAMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jan 16, 2023 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 16, 2023 Accepting new patients
The Southeast Permanente Medical Group Surgery CurrentSince Aug 1, 2016 Accepting new patients
Mission Colon & Rectal Specialists PLLC Colon & Rectal Surgery CurrentSince Mar 3, 2025 Accepting new patients
Healthtexas Provider Network Surgery Current Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

20 Glenlake Pkwy
Sandy Springs, GA 30328
Phone (770) 677-6247

2750 S Preston Rd
Ste 116264
Celina, TX 75009

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: aadewole1135774@direct.sw.org

Organizations & group practices 5

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.

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": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1598907925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 PRAIRIE DR STE 502",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783820",
            "telephone_number": "469-447-4893",
            "fax_number": "469-447-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 PRAIRIE DR STE 502",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783820",
            "telephone_number": "469-447-4893",
            "fax_number": "469-447-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEWOLE",
        "first_name": "ANTHONIA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "SSN/ITIN DELETED",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "GA",
            "license": "073405",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "TX",
            "license": "T9330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.