Divine Access LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

DIVINE ACCESS LLC

Practice address

167 Gilliflower Park
Suwanee, GA 30024-6456

Phone

(770) 983-4084

NPI assigned

May 25, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Udu OladeindeNPI 1417718743

Title

Manager

Phone

(770) 983-4048

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Udu Oladeinde

  • Psychiatric/Mental Health Nurse Practitioner
  • Johns Creek, GA
  • NPI 1417718743
  NPD Authorized official

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

{
    "created_epoch": "1716595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717286400000",
    "number": "1902646292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "P.O.BOX 938",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249998",
            "telephone_number": "770-983-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 GILLIFLOWER PARK",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246456",
            "telephone_number": "770-983-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE ACCESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-25",
        "last_updated": "2024-06-02",
        "certification_date": "2024-06-02",
        "status": "A",
        "authorized_official_last_name": "OLADEINDE",
        "authorized_official_first_name": "UDU",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-983-4048",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Corina Dinulescu, MD
• Direct Healthcare & Supplies Service, LLC
• Direct Healthcare Services
• Direct Healthcare Supplies & Services LLC
• Gina Ditta-Donahue, CNP, FNP-C
• Elizabeth M Dixon, M.D.
• Rosemary Dixon
• Matthew Kybao DO, DMD
• Mehtaab Dobani, NP-C
• Effie S Dolores, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Suwanee, GA
• Providers in Suwanee, 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 Jun 2, 2024; 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.