Organization Active NPI

Loyal Hearts of Service LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1962385278
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LOYAL HEARTS OF SERVICE LLC
Practice address
110 Habersham Dr Ste 149&151
Fayetteville, GA 30214-1381
Phone
(678) 374-1180
NPI assigned
Jul 26, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Authorized official

Name
Oluwafunmilola Sulaimon, DNPNPI 1992330492
Title
DNP,MSN,Pmhnp-BC
Phone
(678) 374-1180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X
Preferred Provider Organization 305R00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

110 Habersham Dr Ste 149&151
Fayetteville, GA 30214-1381

Mailing address

75 Washington St Unit 1717
Fairburn, GA 30213-3617
Phone (678) 374-1180

Other names 1

  • loyal hearts of service Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260403001565 GA Part B Supplier - Clinic/Group Practice 6002391364 Receives reassigned benefits from 1 practitioner
Practice locations: Fayetteville, GA

National Provider Directory

National Provider Directory

Locations

75 Washington St
Unit 1717
Fairburn, GA 30213

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1753488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1962385278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 WASHINGTON ST UNIT 1717",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302133617",
            "telephone_number": "678-374-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HABERSHAM DR STE 149&151",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141381",
            "telephone_number": "678-374-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOYAL HEARTS OF SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-26",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "SULAIMON",
        "authorized_official_first_name": "OLUWAFUNMILOLA",
        "authorized_official_title_or_position": "DNP,MSN,PMHNP-BC",
        "authorized_official_telephone_number": "678-374-1180",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "loyal hearts of service",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.