Individual provider Active NPI

Mary Temilola Abdul, RN-BC, MSN, FNP-BC

  • Family Nurse Practitioner
  • Lithia Springs, GA
National Provider Identifier
1780112789
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN301836 Issued in GA
Practice address
939 Bob Arnold Blvd Ste a&F
Lithia Springs, GA 30122-3258
Phone
(770) 769-1724
NPI assigned
Jun 2, 2017
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F341113-1 NY
Family Nurse Practitioner 363LF0000X APRN301836 GA Primary

Addresses

Primary practice location

939 Bob Arnold Blvd Ste a&F
Lithia Springs, GA 30122-3258

Mailing address

2258 Triple Crown LN
Lithonia, GA 30058-2101
Phone (646) 880-7317

Other practice location 1

1280 Dogwood Dr SE
Conyers, GA 30013-5046
Phone (404) 994-4662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171103002046 NY Practitioner - Nurse Practitioner 2769748987 Reassigns benefits to 3 organizations
I20211103000139 GA Practitioner - Nurse Practitioner 2769748987 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1825 Hwy 32 E
Suite 1200
Newnan, GA 30265

590 Lanier Ave W
Fayetteville, GA 30214-1504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN301836GAMDFamily Nurse Practitioner
F341113-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Jul 1, 2024 Accepting new patients
Wellstreet of Georgia PC CurrentSince Aug 22, 2022 Accepting new patients
Essen Medical Associates, PC CurrentSince Oct 1, 2017 Accepting new patients
True North Health Navigation LLC CurrentSince Oct 1, 2021 Accepting new patients
Essen Medical Associates, PC CurrentSince Oct 1, 2017 Accepting new patients
True North Health Navigation LLC CurrentSince Oct 1, 2021 Accepting new patients
Essen Medical Urgicare, PLLC CurrentSince Oct 1, 2017 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Oct 1, 2017 Accepting new patients
Wellstreet of Georgia PC Past Accepting new patients

Locations

3827 N Lafayette St
Denver, CO 80205
Phone (303) 898-9230

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

1280 Dogwood Dr SE
Conyers, GA 30013
Phone (404) 994-4662

1 W Court Sq
Ste 750
Decatur, GA 30030
Phone (404) 494-7888

5885 Glenridge Dr
Ste 100
Sandy Springs, GA 30328
Phone (678) 321-8546

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Interoperability endpoints

  • Direct secure messaging: mary.lola.abdul.1@27079.direct.athenahealth.com

Organizations & group practices 9

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": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1780112789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2258 TRIPLE CROWN LN",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300582101",
            "telephone_number": "646-880-7317",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 BOB ARNOLD BLVD STE A&F",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301223258",
            "telephone_number": "770-769-1724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1280 Dogwood Dr SE",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300135046",
            "country_code": "US",
            "telephone_number": "404-994-4662",
            "fax_number": "404-994-4663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDUL",
        "first_name": "MARY",
        "middle_name": "TEMILOLA",
        "name_prefix": "Miss",
        "credential": "RN-BC, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-02",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341113-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN301836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia Springs, GA

Sources for this page

Verify at the official NPI Registry.