Individual provider Active NPI

Folasade Omole, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Powder Springs, GA
National Provider Identifier
1700515608
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2021230505 Issued in GA
Practice address
2750 Adams Landing Way
Powder Springs, GA 30127-5069
Phone
(678) 677-2508
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2021230505 GA Primary

Addresses

Primary practice location

2750 Adams Landing Way
Powder Springs, GA 30127-5069

Mailing address

2750 Adams Landing Way
Powder Springs, GA 30127-5069
Phone (678) 677-2508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2021230505GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Uplift Recovery and Wellness Center Inc Psychiatric/Mental Health CurrentSince May 1, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1700515608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 ADAMS LANDING WAY",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301275069",
            "telephone_number": "678-677-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 ADAMS LANDING WAY",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301275069",
            "telephone_number": "678-677-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOLE",
        "first_name": "FOLASADE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "2021230505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powder Springs, GA

Sources for this page

Verify at the official NPI Registry.