Adeyosoye Dawodu, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

036-113848 Issued in IL

Practice address

1300 Franklin Ave
Suite 250
Normal, IL 61761-3592

Phone

(309) 268-3589

Fax

(309) 268-2536

NPI assigned

Jul 8, 2006

Last updated

Jun 23, 2008By 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

Other identifiers 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Atlanta Professional Services LLC

  • Psychologist
  • Atlanta, GA
  • NPI 1316959869

  Hospitalist

  Medicare reassignment Care Compare group NPD
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  Medicare reassignment NPD
• Gwinnett Physician Group, LLC

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1578574661
  Medicare reassignment NPD
• Memorial Family Practice Associates, LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1598869844
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1932132685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE",
            "address_2": "SUITE 250",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613592",
            "telephone_number": "309-268-3589",
            "fax_number": "309-268-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE",
            "address_2": "SUITE 250",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613592",
            "telephone_number": "309-268-3589",
            "fax_number": "309-268-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWODU",
        "first_name": "ADEYOSOYE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036-113848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000549806",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00478520",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200890360",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36113848",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Scott Davis, M.D.
• Laura Davis, RN
• Nancy Davis, CRNA
• Ryan T Davis, MS, ATC
• Dawn Leedie, LCPC. P.C. (Leedie Counseling Services, P.C.)
• Dba Developing Melodies
• Leah Dean, CRNA
• Laura Deffley
• Definitive Neurodiagnostics LLC
• Definitive Neurodiagnostics, LLC Professional Services

• Hospitalist Physician in Normal, IL
• Providers in Normal, IL by specialty
• Hospitalist Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.