Jennifer W Fagbemi, EDS

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

164478 Issued in GA

Practice address

1502 Renaissance Dr NE Apt 2a
Conyers, GA 30012-8026

Phone

(404) 247-5232

Fax

(470) 321-5245

NPI assigned

Apr 29, 2022

Last updated

Apr 29, 2022By the provider in NPPES

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1902541485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 RENAISSANCE DR NE APT 2A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300128026",
            "telephone_number": "404-247-5232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 RENAISSANCE DR NE APT 2A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300128026",
            "telephone_number": "404-247-5232",
            "fax_number": "470-321-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGBEMI",
        "first_name": "JENNIFER",
        "middle_name": "W",
        "name_prefix": "Ms.",
        "credential": "EDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "GA",
            "license": "164478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vannessa Evans, MD
• Zina L. Evans, LCSW
• Excalibur Anesthesia Associates Inc
• Extraordinary Hand Over Hands Associates (Ehoha) LLC
• Melissa Fagan
• Latresia Fair, RN
• Jamie H Fairchild
• Fairview Community Personal Care Home, Inc.
• Sylvia Faison
• Faith Fulfillment Centers

• School Psychologist in Conyers, GA
• Providers in Conyers, GA by specialty
• School Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.