Individual provider Active NPI

Mustapha Taiwo Olorunnimbe, CRNA

  • Certified Registered Nurse Anesthetist
  • Richmond, VA
National Provider Identifier
1801368352
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024177380 Issued in VA
Practice address
1250 E Marshall St
Richmond, VA 23298-5051
Phone
(804) 628-6990
Fax
(804) 628-6932
NPI assigned
Dec 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN290655 GA
Certified Registered Nurse Anesthetist 367500000X 0024177380 VA Primary

Addresses

Primary practice location

1250 E Marshall St
Richmond, VA 23298-5051

Mailing address

301 Karl Linn Dr Apt 317
North Chesterfield, VA 23225-6975

Other practice location 1

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200401001612 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991031494 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC-West Georgia Anesthesia Associates Inc.Group PAC ID 2365456308, 67 clinicians
Grady Memorial Hospital CorporationGroup PAC ID 7517032998, 365 clinicians

Practice addresses (Care Compare)

705 Dixie St
Carrollton, GA 30117-3818
Phone (800) 232-5703

80 Gilmer St SE
Atlanta, GA 30303-3017
Phone (404) 616-1000

Hospital & facility affiliations

  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079
  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
  • Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
TMC-West Georgia Anesthesia Associates Inc. Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2022 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Apr 12, 2023 Accepting new patients
Gi Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2021 Accepting new patients
Piedmont Anesthesia Associates, L.L.C CurrentSince Feb 18, 2020 Accepting new patients
Coastal Ambulatory Anesthesia LLC CurrentSince Nov 19, 2021 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Oct 2, 2023 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 24, 2021 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Oct 2, 2023 Accepting new patients
Primary Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 28, 2025 Accepting new patients
Gastroenterology Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince May 20, 2021 Accepting new patients

Locations (25 of 30)

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

340 N Milledge Ave
Ste A
Athens, GA 30601
Phone (706) 548-0008

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

550 Peachtree St NE
Ste 1600
Atlanta, GA 30308
Phone (404) 881-1094

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1515 River Pl
Ste 320
Braselton, GA 30517
Phone (678) 997-2125

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

2675 N Decatur Rd
Ste 506
Decatur, GA 30033
Phone (404) 299-1679

3904 N Druid Hills Rd
Decatur, GA 30033
Phone (404) 590-4404

8855 Hospital Dr
Ste 102
Douglasville, GA 30134
Phone (678) 784-5020

874 Lanier Ave W
Ste 260
Fayetteville, GA 30214
Phone (404) 407-5959

2324 Limestone Overlook
Ste 200
Gainesville, GA 30501
Phone (312) 724-7441

1955 Textile Way
Gainesville, GA 30501
Phone (678) 987-1499

226 E College St
#A
Griffin, GA 30224
Phone (678) 987-1490

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

1514 Vernon Rd
Lagrange, GA 30240
Phone (706) 812-2369

301 Philip Blvd
Ste B
Lawrenceville, GA 30046
Phone (770) 682-7220

4865 Bill Gardner Pkwy
Locust Grove, GA 30248
Phone (770) 692-0100

488 Kennesaw Ave NW
Ste 100
Marietta, GA 30060
Phone (770) 427-3075

34 Upper Riverdale Rd SE
Ste 201
Riverdale, GA 30274
Phone (678) 904-0094

5671 Ptree Dunwoody Rd NE
Ste 680
Sandy Springs, GA 30342
Phone (404) 705-6985

1139 Lexington Ave
Savannah, GA 31404
Phone (912) 303-4200

Organizations & group practices 10

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1801368352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 KARL LINN DR APT 317",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232256975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985051",
            "telephone_number": "804-628-6990",
            "fax_number": "804-628-6932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467694",
            "country_code": "US",
            "telephone_number": "678-312-1000",
            "fax_number": "678-312-3282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLORUNNIMBE",
        "first_name": "MUSTAPHA",
        "middle_name": "TAIWO",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN290655",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024177380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.