Individual provider Active NPI

Akinlawon Olugbenga Ayeni, M.D.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Largo, MD
National Provider Identifier
1821167149
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
26699 Issued in GA
Practice address
1400 Mercantile LN Ste 180
Largo, MD 20774-5369
Phone
(301) 925-7022
Fax
(301) 925-4463
NPI assigned
Nov 8, 2006
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 26699 GA Primary

Addresses

Primary practice location

1400 Mercantile LN Ste 180
Largo, MD 20774-5369

Mailing address

7137 Fox Harbor Way
Elkridge, MD 21075-6570
Phone (410) 379-8380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, GA, WV, NC4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20150423000384 DE Practitioner - Addiction MedicinePractitioner - Family Practice 4981782331
I20170915000082 GA Practitioner - Addiction Medicine 4981782331 Reassigns benefits to 3 organizations
I20240318002987 WV Practitioner - Addiction Medicine 4981782331 Reassigns benefits to 1 organization
I20240829000573 NC Practitioner - Addiction Medicine 4981782331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Addiction Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sophroneo Psychiatry PCGroup PAC ID 2961883251, 2 clinicians

Practice addresses (Care Compare)

129 Deanna St
Comfort, WV 25049
Phone (470) 671-7575

1870 The Exchange SE
Suite 20026
Atlanta, GA 30339-2036
Phone (770) 829-7442

2620 W Arrowood Rd
Suite 102
Charlotte, NC 28273-6262
Phone (703) 408-8328

4170 Old Austell Rd
Powder Springs, GA 30127-2691
Phone (770) 999-9495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32306WVMDLicensed Practical Nurse
026699GAMDPharmacist
26699GAMDAddiction Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Akin Ayeni MD and Associates Inc Single Specialty CurrentSince Jan 1, 2022 Accepting new patients
Medmark Treatment Centers of Georgia, Inc. CurrentSince Dec 26, 2021 Accepting new patients
Sophroneo Psychiatry, P.C. Single Specialty CurrentSince Jan 1, 2025 Accepting new patients
Uplift Recovery and Wellness Center Inc Single Specialty CurrentSince Jul 14, 2024 Accepting new patients
Personal Recovery Network LLC Single Specialty CurrentSince May 1, 2017 Accepting new patients
Augusta Addiction Associates CurrentSince Dec 26, 2021 Accepting new patients

Locations

1870 The Exchange SE
Ste 200
Atlanta, GA 30339
Phone (404) 558-3297

1870 The Exchange SE
Ste 20026
Atlanta, GA 30339
Phone (770) 829-7442

1668 Mulkey Rd
Ste D4
Austell, GA 30106

4170 Old Austell Rd
Powder Springs, GA 30127
Phone (470) 593-8652

5200 Dallas Hwy
Ste 200134
Powder Springs, GA 30127

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

2620 W Arrowood Rd
Ste 102
Charlotte, NC 28273
Phone (703) 408-8328

Organizations & group practices 6

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1821167149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7137 FOX HARBOR WAY",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756570",
            "telephone_number": "410-379-8380",
            "fax_number": "301-925-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MERCANTILE LN STE 180",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745369",
            "telephone_number": "301-925-7022",
            "fax_number": "301-925-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYENI",
        "first_name": "AKINLAWON",
        "middle_name": "OLUGBENGA",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "GA",
            "license": "26699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.