NPIMap

Organization Active NPI

South Dekalb Family Physicians, LLC

  • Family Medicine Physician
  • Decatur, GA
National Provider Identifier
1992970925
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
170009 Issued in GA
Legal business name
SOUTH DEKALB FAMILY PHYSICIANS, LLC
Practice address
5243 Snapfinger Woods Dr
Suite 104
Decatur, GA 30035-4000
Phone
(770) 981-5511
Fax
(770) 987-6928
NPI assigned
Apr 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Dr. Adebayo A Akintobi, M.D., M.P.H.NPI 1154497626
Title
M.D.
Phone
(770) 981-5511

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 170009 GA Primary

Addresses

Primary practice location

5243 Snapfinger Woods Dr
Suite 104
Decatur, GA 30035-4000

Mailing address

5243 Snapfinger Woods Dr
Suite 104
Decatur, GA 30035-4000
Phone (770) 981-5511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041116000837 GA Part B Supplier - Clinic/Group Practice 1456315712 Receives reassigned benefits from 2 practitioners
Practice locations: Decatur, GA

National Provider Directory

National Provider Directory

Locations

2663 Easterly Pl
Decatur, GA 30035
Phone (770) 981-5511

Practitioners & affiliated clinicians

Practitioners 4

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": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1992970925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5243 SNAPFINGER WOODS DR",
            "address_2": "SUITE 104",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354000",
            "telephone_number": "770-981-5511",
            "fax_number": "770-987-6928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5243 SNAPFINGER WOODS DR",
            "address_2": "SUITE 104",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354000",
            "telephone_number": "770-981-5511",
            "fax_number": "770-987-6928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DEKALB FAMILY PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "AKINTOBI",
        "authorized_official_first_name": "ADEBAYO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "770-981-5511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., M.P.H."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "170009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.