Mofolasade Adeyi, M.D.
Individual provider Active NPI Family Medicine Physician · Canton, GA
NPI 1669730552 · NPPES record last updated Mar 12, 2025
Key facts
- NPI
- 1669730552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 79925 (GA)
- Practice address
- 3290 Sixes Rd
Canton, GA 30114-9102 - Phone
- (678) 374-7514
- Fax
- (770) 914-1070
- NPI assigned
- Apr 27, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Howard University College of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aylo Health, LLC
Practice addresses (Care Compare)
3290 Sixes Rd
Canton, GA 30114-9102
Phone (770) 914-0116
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 |
|---|---|---|---|---|
| I20210305000976 | GA | Practitioner - Family Practice | 3971826678 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aylo Health, LLC | Current |
Accepting new patients | |
| Aylo Health, LLC | Family Medicine | Current |
Accepting new patients |
| Aylo Health, LLC | Family Medicine | Current | Accepting new patients |
| Aylo Health, LLC | Past | Accepting new patients | |
| Aylo Health, LLC | Family Medicine | Past | Accepting new patients |
Locations
3333 Riverwood Pkwy SE
Ste 250
Atlanta, GA 30339
Phone (770) 914-0016
8111 Ball Ground Hwy
Ball Ground, GA 30107
Phone (770) 268-4011
6613 Hickory Flat Hwy
Canton, GA 30115
Phone (770) 268-4357
3290 Sixes Rd
Canton, GA 30114
Phone (678) 374-7514
145 Eagles Walk
Ste A
Stockbridge, GA 30281
Phone (770) 389-3855
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101260600 | VA | |
| Family Medicine Physician | 207Q00000X | 79925 | GA | Yes |
Addresses
Primary practice location
3290 Sixes Rd
Canton, GA 30114-9102
Mailing address
3333 Riverwood Pkwy SE Ste 250
Atlanta, GA 30339-3304
Phone (770) 914-0116
Other practice location 1
1575 Mount Vernon Rd
Dunwoody, GA 30338-4146
Phone (404) 996-0197
Other names
- Folasade Olowude
Other providers in Canton, GA
- Emma D Adams
- Nikole Dawn Adamson
- Rebekah Adamson
- Adaptive Attitudes in Fitness, Inc
- Erica Addison
- Adin Homehealth Care
- Advanced Center for Joint Replacement Cherokee, LLC
- Advanced Urology Institute of Georgia PC
- Advanced Wound and Ostomy Solutions
- Aegis Group Practice LLC
All providers in Canton, GA · Family Medicine 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 Mar 12, 2025. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.