Abibat (Wendy) Yewande Balogun

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN194681 Issued in GA

Practice address

1121 Johnson Ferry Rd
Marietta, GA 30068-5425

Phone

(770) 694-6349

NPI assigned

Mar 28, 2023

Last updated

Mar 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Avant Behavioral Consultants Inc

  • Psychiatry Physician
  • Austell, GA
  • NPI 1598250342
  NPD (past)

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1992409544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 JOHNSON FERRY RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685425",
            "telephone_number": "770-694-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 JOHNSON FERRY RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685425",
            "telephone_number": "770-694-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALOGUN",
        "first_name": "ABIBAT (WENDY)",
        "middle_name": "YEWANDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN194681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison G. Ball, M.D.
• Sameerah Ball, NP
• David C Ballard, III III, MD
• Jeffery B Ballard, DMD
• Kevin M. Ballard, P.A.
• Joan Pauline Garcia Balongag
• Pinang G Balsara
• Supriti Balyan, DDS
• Allyson Balzuweit, RD,LD,MPH
• Akosua Bamfoah

• Psychiatric/Mental Health Nurse Practitioner in Marietta, GA
• Providers in Marietta, 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 Mar 28, 2023; 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.