Active NPI
Aduragbemi Juliana Ayeni
- Colon & Rectal Surgery Physician
- Atlanta, GA
National Provider Identifier
1962907576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- W6431
- Practice address
- 720 Westview Dr SW
Atlanta, GA 30310-1458 - Phone
- (404) 616-7847
- NPI assigned
- Mar 26, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Colon & Rectal Surgery Physician | 208C00000X | W6431 | TX | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Surgery Physician | 208600000X | W6431 | TX |
Addresses
Primary practice location
720 Westview Dr SW
Atlanta, GA 30310-1458
Mailing address
3102 Hillside Landing TRL
Katy, TX 77494-7242
Phone (404) 729-9296
Other practice location 1
920 Medical Plaza Dr Ste 330
Shenandoah, TX 77380-3271
Phone (832) 663-0037
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180918004357 | GA | Order and Referring Only - Colorectal Surgery (Proctology) | 6709137565 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- aayeni3571659@adventhealth.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784505600000",
"number": "1962907576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3102 HILLSIDE LANDING TRL",
"city": "KATY",
"state": "TX",
"postal_code": "774947242",
"telephone_number": "404-729-9296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 WESTVIEW DR SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303101458",
"telephone_number": "404-616-7847"
}
],
"practiceLocations": [
{
"address_1": "920 Medical Plaza Dr Ste 330",
"address_purpose": "LOCATION",
"city": "Shenandoah",
"state": "TX",
"postal_code": "773803271",
"country_code": "US",
"telephone_number": "832-663-0037",
"fax_number": "281-962-3033",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AYENI",
"first_name": "ADURAGBEMI",
"middle_name": "JULIANA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-26",
"last_updated": "2026-07-20",
"certification_date": "2026-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "TX",
"license": "W6431",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "W6431",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.