DR. IFEOLUWA OGUNBADENIYI (NPI# 1912392754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912392754 |
| Entity Type | Individual |
| Full Name | DR. IFEOLUWA OGUNBADENIYI |
| Credential | M.D |
| Practice Address |
1240 Eagles Landing Pkwy Ste 110 Stockbridge GA 30281-5173 |
| Practice Telephone | 7703893855 |
| Practice Fax Number | 7704748078 |
| Mailing Telephone | 7703893855 |
| Mailing Fax Number | 7704748078 |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2019-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 81128 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1240 EAGLES LANDING PKWY STE 110 |
| City | STOCKBRIDGE |
| State | GA |
| Zip Code | 30281-5173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306834262 | Melvin J Williams Jr. | Family Medicine | 1240 Eagles Landing Pkwy Ste 110, Stockbridge, GA 30281-5173 | 2005-10-13 |
| 1962010785 | Drew Thompson | Nurse Practitioner | 1240 Eagles Landing Pkwy Ste 110, Stockbridge, GA 30281-5173 | 2020-07-17 |
| 1760002893 | Stephanie Nicole Elliott | Nurse Practitioner | 1240 Eagles Landing Pkwy Ste 110, Stockbridge, GA 30281-5173 | 2020-04-18 |
| 1871051011 | William Logan Layfield | Physician Assistant | 1240 Eagles Landing Pkwy Ste 110, Stockbridge, GA 30281-5173 | 2019-03-06 |
| 1013482447 | Niraj Baldev Patel | Physician Assistant | 1240 Eagles Landing Pkwy Ste 110, Stockbridge, GA 30281-5173 | 2018-10-12 |
| 1316432578 | Lily Ngoc Phan | Nurse Practitioner | 1240 Eagles Landing Pkwy Ste 110, Stockbridge, GA 30281-5173 | 2018-06-28 |
| 1962996603 | Martin Lynn Kenser | Nurse Practitioner | 1240 Eagles Landing Pkwy Ste 110, Stockbridge, GA 30281-5173 | 2018-06-16 |
| 1124520101 | Thuy-an Hoang Nguyen | Nurse Practitioner | 1240 Eagles Landing Pkwy Ste 110, Stockbridge, GA 30281-5173 | 2018-03-06 |
| 1194189571 | Christina Price-jackson | Family Medicine | 1240 Eagles Landing Pkwy Ste 110, Stockbridge, GA 30281-5173 | 2016-04-11 |
| 1922469154 | Miranda Oliver Stone | Physician Assistant | 1240 Eagles Landing Pkwy Ste 110, Stockbridge, GA 30281-5173 | 2016-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039095 | Colette Alls | Social Worker | 447 Lakeshore Dr, Stockbridge, GA 30281 | 2020-09-24 |
| 1982216800 | Pediatric and Family Behavioral Health of Georgia | Counselor | 1004 Ulster Court, Stockbridge, GA 30281 | 2020-08-21 |
| 1518577659 | Qunique Taveka Toxey | Behavior Technician | 115 N Park Trail, Suite 123, Stockbridge, GA 30281 | 2020-08-04 |
| 1497377675 | Melanie Harvey | Pharmacist | 4467 North Henry Boulevard, Stockbridge, GA 30281 | 2020-05-11 |
| 1114550571 | Cecile Maria Dunkley Layne | Counselor | 255 Corporte Drive, Stockbridge, GA 30281 | 2020-02-13 |
| 1306407143 | Palliative Care of Georgia. LLC | Home Health | 275 Corporate Center Court Ste C, Stockbridge, GA 30281 | 2019-06-24 |
| 1154883791 | Aaliyah Nura Fardan-alexander | Nurse's Aide | 105 Singletree, Stockbridge, GA 30281 | 2019-04-02 |
| 1306306261 | Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 150 County Club Drive, Suite 200, Stockbridge, GA 30281 | 2019-03-25 |
| 1356814172 | Kristina Louissaint | Nurse Practitioner | 650 Country Club Dr, Stockbridge, GA 30281 | 2019-01-03 |
| 1942789284 | Cameren Barnes | Physical Therapist | 5473 N Henry Blvd, Stockbridge, GA 30281 | 2018-08-08 |
| Find all providers in zip 30281 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104487958 | Southern Crescent Internal Medicine, LLC | Internal Medicine | 7444 Hannover Pkwy S Ste 225, Stockbridge, GA 30281-7847 | 2019-06-24 |
| 1427567072 | Ca&i Medical Services, LLC | Internal Medicine | 1215 Eagles Landing Pkwy Ste 202, Stockbridge, GA 30281-7280 | 2017-09-27 |
| 1023465275 | Zam Zam Medical Clinic LLC | Internal Medicine | 138 Surge Stone Ln, Stockbridge, GA 30281-4314 | 2016-05-18 |
| 1184975278 | Southern Medical Clinic, LLC | Internal Medicine | 5329 N Henry Blvd, Stockbridge, GA 30281-3224 | 2012-09-28 |
| 1992022719 | Alicia Shelly | Internal Medicine | 235 Medical Blvd Ste B, Stockbridge, GA 30281-7218 | 2010-05-03 |
| 1700062759 | Tricia D. Ferguson | Internal Medicine | 175 Medical Blvd, Vamc Stockbridge Cboc, Stockbridge, GA 30281-5083 | 2008-01-20 |
| 1245413715 | Med-south Primary Care | Internal Medicine | 1240 Eagles Landing Parkway, Suite 100, Stockbridge, GA 30281 | 2007-12-07 |
| 1750580064 | Adebola Ogunmodede | Internal Medicine | 516 Winter View Way, Stockbridge, GA 30281-9115 | 2007-07-16 |
| 1659409043 | Denise Cheryl De Veranez | Internal Medicine | 285 Country Club Dr, Suite 200, Stockbridge, GA 30281-7350 | 2007-02-28 |
| 1518028182 | Phyllis May Barracks | Internal Medicine | 9020 Peridot Pkwy, Stockbridge, GA 30281-9417 | 2006-12-13 |
| Find all providers in STOCKBRIDGE | ||||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.