Individual provider Active NPI

Olubunkola Moremi Olubi, MD

  • Cardiovascular Disease Physician
  • Fayetteville, GA
National Provider Identifier
1962496992
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
056613 Issued in GA
Practice address
1267 Highway 54 W
Suite 2200
Fayetteville, GA 30214-2114
Phone
(770) 253-0611
Fax
(770) 502-0521
NPI assigned
Sep 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 056613 GA Primary

Addresses

Primary practice location

1267 Highway 54 W
Suite 2200
Fayetteville, GA 30214-2114

Mailing address

1267 Highway 54 W
Suite 2200
Fayetteville, GA 30214-2114
Phone (770) 253-0611

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20051019000231 GA Practitioner - Cardiovascular Disease (Cardiology) 5193741155 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

1975 Hwy 54 W
Peachtree City, GA 30269-4794
Phone (770) 683-8346

20 Francis Way
Sharpsburg, GA 30277-3589

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 253-1912

795 Poplar Rd
Suite 400
Newnan, GA 30265-2590
Phone (770) 254-6089

Hospital & facility affiliations

  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229
  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Nov 3, 2009 Accepting new patients
City of Hope Medical Group of Georgia LLC CurrentSince Mar 17, 2013 Accepting new patients
Fayette Community Hospital, Inc. Past Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients

Locations

275 Collier Rd NW
Ste 500
Atlanta, GA 30309
Phone (404) 355-6562

275 Collier Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 350-0009

95 Collier Rd NW
Ste 2035
Atlanta, GA 30309
Phone (404) 355-9815

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1267 Highway 54 W
Ste 2100
Fayetteville, GA 30214
Phone (770) 461-1407

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

1267 Highway 54 W
Ste 2300
Fayetteville, GA 30214
Phone (770) 719-6747

220 J L White Dr
Ste 150
Jasper, GA 30143
Phone (706) 253-2430

1015 Lafayette Pkwy
Ste 130
Lagrange, GA 30241
Phone (470) 489-0090

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

20 Francis Way
Ste 201
Sharpsburg, GA 30277
Phone (770) 254-6089

20 Francis Way
Ste 101
Sharpsburg, GA 30277
Phone (404) 352-1611

62742 Collections Ctr Dr
Chicago, IL 60693

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1962496992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W",
            "address_2": "SUITE 2200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142114",
            "telephone_number": "770-253-0611",
            "fax_number": "770-502-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W",
            "address_2": "SUITE 2200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142114",
            "telephone_number": "770-253-0611",
            "fax_number": "770-502-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUBI",
        "first_name": "OLUBUNKOLA",
        "middle_name": "MOREMI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-06",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "056613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.