Individual provider Active NPI

Monica Richardson Ademola, FNP

  • Family Nurse Practitioner
  • Brunswick, GA
National Provider Identifier
1679226807
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN249568 Issued in GA
Practice address
150 Scranton Connector
Brunswick, GA 31525-0540
Phone
(912) 262-2300
Fax
(912) 262-3333
NPI assigned
Jan 28, 2022
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN249568 GA
Family Nurse Practitioner 363LF0000X RN249568 GA Primary

Addresses

Primary practice location

150 Scranton Connector
Brunswick, GA 31525-0540

Mailing address

35 Rice Mill Rd
Port Wentworth, GA 31407-6023
Phone (912) 352-6388

Other practice location 1

1512 Bull St Unit 6
Savannah, GA 31401-7255
Phone (912) 200-6490

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220218001168 GA Practitioner - Nurse Practitioner 1850785783 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN249568GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Immediate Care FP, LLC CurrentSince Mar 1, 2022 Accepting new patients
Applecare Memorial Immediate Care Joint Venture LLC CurrentSince Mar 1, 2022 Accepting new patients

Locations

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

14089 Abercorn St
Savannah, GA 31419
Phone (912) 349-4945

1512 Bull St
Unit 6
Savannah, GA 31401
Phone (912) 200-6490

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 2

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": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1679226807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 RICE MILL RD",
            "city": "PORT WENTWORTH",
            "state": "GA",
            "postal_code": "314076023",
            "telephone_number": "912-352-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SCRANTON CONNECTOR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250540",
            "telephone_number": "912-262-2300",
            "fax_number": "912-262-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1512 Bull St Unit 6",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314017255",
            "country_code": "US",
            "telephone_number": "912-200-6490",
            "fax_number": "912-200-6590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADEMOLA",
        "first_name": "MONICA",
        "middle_name": "RICHARDSON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN249568",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN249568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.