Individual provider Active NPI

Lawrence Ogagaoghene Adu, MD

  • Psychiatry Physician
  • Gainesville, FL
National Provider Identifier
1679597702
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME84024 Issued in FL
Practice address
1103 SW 2ND Ave
Gainesville, FL 32601-6116
Phone
(352) 378-9116
Fax
(352) 378-9779
NPI assigned
Jul 26, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME84024 FL
Psychiatry Physician 2084P0800X ME84024 FL Primary

Addresses

Primary practice location

1103 SW 2ND Ave
Gainesville, FL 32601-6116

Mailing address

1103 SW 2ND Ave Ste C
Gainesville, FL 32601-6116
Phone (352) 378-9116

Other practice location 1

1026 SW 2nd Ave
Suite C
Gainesville, FL 32601-6134
Phone (352) 378-9116

Other identifiers 2

IdentifierTypeStateIssuer
28806OtherBCBS
274635200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060207000326 FL Practitioner - PsychiatryPractitioner - Addiction Medicine 1951315365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1103 SW 2ND Ave
Gainesville, FL 32601-6116
Phone (352) 378-9116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME84024FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gainesville Psychiatry and Forensic Services L.L.C. CurrentSince Oct 10, 2005 Accepting new patients

Locations

1026 SW 2nd Ave
Ste C
Gainesville, FL 32601
Phone (352) 378-9116

1103 SW 2nd Ave
Gainesville, FL 32601
Phone (352) 375-1212

1103 SW 2nd Ave
Ste C
Gainesville, FL 32601

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679597702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 SW 2ND AVE STE C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326016116",
            "telephone_number": "352-378-9116",
            "fax_number": "352-378-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 SW 2ND AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326016116",
            "telephone_number": "352-378-9116",
            "fax_number": "352-378-9779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1026 SW 2nd Ave",
            "address_2": "SUITE C",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326016134",
            "country_code": "US",
            "telephone_number": "352-378-9116",
            "fax_number": "352-378-9779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADU",
        "first_name": "LAWRENCE",
        "middle_name": "OGAGAOGHENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME84024",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME84024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "28806",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274635200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.