Oluyele Jonathan Omidina, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT011709 Issued in GA

Practice address

1205 Johnson Ferry Rd
Ste 130
Marietta, GA 30068-5418

Phone

(770) 565-3201

Fax

(770) 565-3203

NPI assigned

Oct 1, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1851794119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-8907",
            "fax_number": "423-954-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 JOHNSON FERRY RD",
            "address_2": "STE 130",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685418",
            "telephone_number": "770-565-3201",
            "fax_number": "770-565-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMIDINA",
        "first_name": "OLUYELE",
        "middle_name": "JONATHAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin L Olson, PHARM.D.
• Bolanle Olumide
• Olympian Surgical Assistants
• Prisilla Omana, RBT
• Omega Health Care LLC
• Emily Fatemeh Omidy, PT, DPT
• Omni Solutions LLC
• Sarah Omodele, DNP, APRN, FNP-C
• Omokhuale Omokhodion, M.D
• Peace Omowonuola

• Physical Therapist in Marietta, GA
• Providers in Marietta, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.