Basirat Oladunni Shomuyiwa

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN136389 Issued in GA

Practice address

11340 Lakefield Dr Ste 200
Johns Creek, GA 30097-2456

Phone

(678) 895-8405

NPI assigned

Oct 1, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitae Health Medical Georgia LLCGroup PAC ID 4183079577, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Upperhealth Wellness Center LLC

  • Psychiatric/Mental Health Registered Nurse
  • Johns Creek, GA
  • NPI 1154208577

  Single Specialty

  Medicare reassignment NPD Authorized official
• Vitae Health Medical Georgia LLC

  • Internal Medicine Physician
  • Cartersville, GA
  • NPI 1184320574
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1730907338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 HERRINGTON RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300447503",
            "telephone_number": "678-895-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 LAKEFIELD DR STE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300972456",
            "telephone_number": "678-895-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOMUYIWA",
        "first_name": "BASIRAT",
        "middle_name": "OLADUNNI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN136389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seong Sool Shim, MD
• Shimley Enterprises, LLC
• On Joong Shin, D.C./L.AC.
• Kaveh Shokoufi Moghiman, D.M.D
• Christopher Ross Sholota, DDS
• David R. Shore, RPH.
• Cally Taylor Short, APC
• Sabrin Nur Shufa
• Wanda Shull
• Eve Shumate, LAPC

• Psychiatric/Mental Health Nurse Practitioner in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.