Individual provider Active NPI

Adebanke Olufunmilayo Oderinde, MD

  • Emergency Medicine Physician
  • Gainesville, GA
National Provider Identifier
1841949930
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
104496 Issued in GA
Practice address
743 Spring St NE Ste 710
Gainesville, GA 30501-3715
Phone
(770) 219-8730
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 104496 GA Primary

Addresses

Primary practice location

743 Spring St NE Ste 710
Gainesville, GA 30501-3715

Mailing address

743 Spring St NE
Gainesville, GA 30501-3899
Phone (770) 219-8730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MS2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20250917002849 GA Practitioner - Emergency Medicine 8426439894 Reassigns benefits to 1 organization
I20260522002271 MS Practitioner - Emergency Medicine 8426439894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Emergency Department Services, P.C.Group PAC ID 5597751032, 76 clinicians

Practice addresses (Care Compare)

1400 River PL
Braselton, GA 30517-5600
Phone (770) 219-9000

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 503-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104496GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Emergency Department Services, P.C. Emergency Medicine CurrentSince Aug 11, 2025 Accepting new patients

Locations

743 Spring St NE
Rear
Gainesville, GA 30501
Phone (770) 219-1200

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

743 Spring St NE
Ste 710
Gainesville, GA 30501
Phone (770) 219-1200

Organizations & group practices 2

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 4

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": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1841949930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013899",
            "telephone_number": "770-219-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE STE 710",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODERINDE",
        "first_name": "ADEBANKE",
        "middle_name": "OLUFUNMILAYO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "104496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.