Organization Active NPI

Strongtower Behavioral Healthcare LLC

  • Psychiatry Physician
  • Marietta, GA
National Provider Identifier
1689938326
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
64802 Issued in GA
Legal business name
STRONGTOWER BEHAVIORAL HEALTHCARE LLC
Doing business as
Koolnight Insomnia and Sleep Services
Practice address
3750 Palladian Village Dr
Suite 110 & 120
Marietta, GA 30066-8200
Phone
(678) 265-8361
Fax
(678) 265-8362
NPI assigned
Jun 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Authorized official

Name
Dr. Opeoluwa Olabisi Akinnusi, MDNPI 1770731713
Title
Ceo
Phone
(678) 218-9586

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X 064741 GA
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 64802 GA Primary

Addresses

Primary practice location

3750 Palladian Village Dr
Suite 110 & 120
Marietta, GA 30066-8200

Mailing address

3750 Palladian Village Dr
Suite 110 & 120
Marietta, GA 30066-8200
Phone (678) 265-8361

Other identifiers 1

IdentifierTypeStateIssuer
64802OtherGAMEDICAL LICENCE NUMBER

Other names 1

  • Koolnight Insomnia and Sleep Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120820000063 GA Part B Supplier - Clinic/Group Practice 2961658315 Receives reassigned benefits from 1 practitioner
Practice locations: Marietta, GA

National Provider Directory

National Provider Directory

Locations

3750 Palladian Village Dr
Ste 110
Marietta, GA 30066
Phone (678) 265-8361

2617 Sandy Plains Rd
Ste C
Marietta, GA 30066
Phone (678) 265-8361

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFFFBD

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1689938326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 PALLADIAN VILLAGE DR",
            "address_2": "SUITE 110 & 120",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300668200",
            "telephone_number": "678-265-8361",
            "fax_number": "678-265-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 PALLADIAN VILLAGE DR",
            "address_2": "SUITE 110 & 120",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300668200",
            "telephone_number": "678-265-8361",
            "fax_number": "678-265-8362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRONGTOWER BEHAVIORAL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-27",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "AKINNUSI",
        "authorized_official_first_name": "OPEOLUWA",
        "authorized_official_middle_name": "OLABISI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-218-9586",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "GA",
            "license": "064741",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "64802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENCE NUMBER",
            "identifier": "64802",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Koolnight Insomnia and Sleep Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.