Individual provider Active NPI

Iyabode F Akinsanya-Beysolow, M.D.,M.P.H.

  • Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1609873934
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
044618 Issued in GA
Practice address
3915 Cascade Rd SW
Promenade Park Building,Suite 310
Atlanta, GA 30331-8512
Phone
(404) 699-1339
Fax
(404) 699-1380
NPI assigned
Jul 1, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 044618 GA Primary

Addresses

Primary practice location

3915 Cascade Rd SW
Promenade Park Building,Suite 310
Atlanta, GA 30331-8512

Mailing address

3305 Hidden Trail Rd SE
Smyrna, GA 30082-2442
Phone (404) 699-1339

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
I20160525000772 GA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6002105442

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
044618GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Pediatric Partners PC Pediatrics Past Accepting new patients

Organizations & group practices 1

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609873934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 HIDDEN TRAIL RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300822442",
            "telephone_number": "404-699-1339",
            "fax_number": "404-699-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW",
            "address_2": "PROMENADE PARK BUILDING,SUITE 310",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318512",
            "telephone_number": "404-699-1339",
            "fax_number": "404-699-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKINSANYA-BEYSOLOW",
        "first_name": "IYABODE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.,M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "044618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.