Individual provider Active NPI

Folake Olumayowa Taylor, M.D.

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1962543306
Registry record updated Dec 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
058360 Issued in GA
Practice address
3921 Shallowford Rd
Marietta, GA 30062-5013
Phone
(770) 649-0049
Fax
(770) 649-9092
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 058360 GA Primary

Addresses

Primary practice location

3921 Shallowford Rd
Marietta, GA 30062-5013

Mailing address

3921 Shallowford Rd
Marietta, GA 30062-5013
Phone (770) 649-0049

Other identifiers 4

IdentifierTypeStateIssuer
384386095CMedicaidGA
058360OtherGAMEDICAL LICENSE
384386095BMedicaidGA
384386095AMedicaidGA

Other names 1

  • Dr. Folake Olumayowa Kolawole Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
058360GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carrollton Pediatric Clinic, P.C. Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ftaylor33278@directwellstar.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388188800000",
    "number": "1962543306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 SHALLOWFORD RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625013",
            "telephone_number": "770-649-0049",
            "fax_number": "770-649-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 SHALLOWFORD RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625013",
            "telephone_number": "770-649-0049",
            "fax_number": "770-649-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "FOLAKE",
        "middle_name": "OLUMAYOWA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2013-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "058360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "384386095C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "058360",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "384386095B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "384386095A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FOLAKE",
            "last_name": "KOLAWOLE",
            "middle_name": "OLUMAYOWA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2013; 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.