Olugbenga David Sogbamu

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN277331 Issued in GA

Practice address

3661 Deaton TRL
Buford, GA 30519-1110

Phone

(334) 612-8501

NPI assigned

Jul 27, 2023

Last updated

Jul 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindbodysoul Mental Health and Family Practice LLCGroup PAC ID 8729432489, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindbodysoul Mental Health & Family Practice LLC

  • Family Nurse Practitioner
  • Decatur, GA
  • NPI 1225776834

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1851072474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3661 DEATON TRL",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305191110",
            "telephone_number": "334-612-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 DEATON TRL",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305191110",
            "telephone_number": "334-612-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOGBAMU",
        "first_name": "OLUGBENGA",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN277331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydell Deon Smith, LAPC, CRC
• Sarah Catherine Smith, M.S. CCC-SLP
• Tekesha Smith, LCSW
• Timothy Smith, DC
• Mary L Snavely, PTA
• Ricardo Nicolas Solis
• Solutions of Life, LLC
• Lucy Greer Sorto, NP
• Rebecca Chasteen Sosebee, O.D.
• Southern Pathways Counseling, LLC

• Psychiatric/Mental Health Nurse Practitioner in Buford, GA
• Providers in Buford, 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 Jul 27, 2023; 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.