Damilola Omotayo Mohammed

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN291979 Issued in GA

Practice address

409 W Solomon St
Griffin, GA 30223-2831

Phone

(904) 440-4961

NPI assigned

Jan 31, 2022

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: damilola.mohammed.p1@direct.smcmed.nextgenshare.com

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.

• Southside Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1235123993
  Medicare reassignment NPD
• Famo Healthcare Services II LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Peachtree City, GA
  • NPI 1972218477
  NPD Authorized official
• Southside Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Jonesboro, GA
  • NPI 1821981234
  NPD
• Southside Medical Center, Inc.

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1174641658
  NPD (past)

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1902559982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 GLENRIDGE CONNECTOR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W SOLOMON ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302232831",
            "telephone_number": "904-440-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "DAMILOLA",
        "middle_name": "OMOTAYO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN291979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Mims, AMT
• Jennifer A Mitchell
• Shonkethia Mitchell, NP
• Arian Mizani
• Modern Podiatry, LLC
• Frank Howard Mondary, RN260659
• Priyasi Monga, MD
• Sreeja Moolamalla, MD
• Kyong Rok Moon, M.D.
• Toni Moore-Stewart, RN

• Family Nurse Practitioner in Griffin, GA
• Providers in Griffin, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.