Aisha Adigun
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Stone Mountain, GA
NPI 1861271975 · NPPES record last updated Dec 19, 2024
Key facts
- NPI
- 1861271975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- RN286228 (GA)
- Practice address
- 5385 Five Forks Trickum Rd Ste F
Stone Mountain, GA 30087-3018 - Phone
- (770) 766-3003
- Fax
- (770) 599-5966
- NPI assigned
- Sep 27, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241111000469 | GA | Practitioner - Nurse Practitioner | 1456885706 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN286228 | GA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Psychiatric/Mental Health | Current |
Accepting new patients |
| Recovery Consultants of Atlanta, Inc. | Current |
Accepting new patients | |
| Recovery Consultants of Atlanta, Inc. | Current |
Accepting new patients | |
| Green Mind Behavioral Health Services LLC | Psychiatric/Mental Health | Past |
Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964
4229 Snapfinger Woods Dr
Decatur, GA 30035
Phone (404) 286-9252
3423 Covington Dr
Ste B
Decatur, GA 30032
Phone (404) 284-6061
1957 Lakeside Pkwy
Ste 510
Tucker, GA 30084
Phone (404) 289-0313
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DEGGAD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN286228 | GA | Yes |
Addresses
Primary practice location
5385 Five Forks Trickum Rd Ste F
Stone Mountain, GA 30087-3018
Mailing address
5385 Five Forks Trickum Rd Ste F
Stone Mountain, GA 30087-3018
Phone (770) 766-3003
Other providers in Stone Mountain, GA
- Ac Speech Therapy
- Access Home Care, LLC
- Catherine Adams
- Frank Adams
- Muna Muhammed Aden
- Advance Cognitive Care LLC
- Afc Health Care Services
- Affiliated Behavioral Medical Group
- Affordable Care Services and Enterprises, LLC
- Affordable Dentures & Implants of Georgia IV, LLC
All providers in Stone Mountain, GA · Psychiatric/Mental Health Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.