Olufunke Adewunmi, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN234254 Issued in GA

Practice address

3995 S Cobb Dr SE
Smyrna, GA 30080-6342

Phone

(770) 431-7071

Fax

(770) 431-7031

NPI assigned

Jun 6, 2018

Last updated

Jun 6, 2018By 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 names 1

• Olufunke Mukomi Olushola Other name

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

Credentials

Nurse Practitioner

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.

• Bold Ark LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Loganville, GA
  • NPI 1740079623
  Medicare reassignment NPD Authorized official
• Vest Monroe, LLC

  dba Ridgeview Institute Monroe

  • Psychiatric Hospital
  • Monroe, GA
  • NPI 1073069944
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  GA, Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1942793773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3995 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806342",
            "telephone_number": "770-431-7071",
            "fax_number": "770-431-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3995 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806342",
            "telephone_number": "770-431-7071",
            "fax_number": "770-431-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEWUNMI",
        "first_name": "OLUFUNKE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN234254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLUFUNKE",
            "last_name": "OLUSHOLA",
            "middle_name": "MUKOMI",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Addus Healthcare (South Carolina), Inc. (Addus HomeCare)
• Olasupo Adedapo-Jimoh, MD
• Lathonia Adekunle
• Adegboyega A Adesokan, MD
• Adesse Healthcare Solutions Inc.
• Adeyemi House PC (South Atlantic Internal Medicine Associates)
• Ayomide Henrietta Adeyemi, MD
• Tolulope Adeyemo, MD
• Advanced Foot and Ankle Institute of Georgia
• Abimbola Olayemi Agbaere

• Psychiatric/Mental Health Nurse Practitioner in Smyrna, GA
• Providers in Smyrna, 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 6, 2018; 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.