DR. IYABO O OTEKUNRIN (NPI# 1437634417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1437634417 |
Entity Type | Individual |
Full Name | DR. IYABO O OTEKUNRIN |
Credential | MD |
Practice Address |
1000 Briarcliff Rd Ne Atlanta GA 30306-2618 |
Mailing Address |
1410 Willow Lake Dr Ne Atlanta GA 30329-2804 |
Practice Telephone | 4046984281 |
Mailing Telephone | 6788869651 |
Enumeration Date | 2018-09-26 |
Last Update Date | 2018-09-26 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 133N00000X | Nutritionist | Dietary & Nutritional Service Providers | ||
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
N | 102X00000X | Poetry Therapist | Behavioral Health & Social Service Providers |
Street Address |
1000 BRIARCLIFF RD NE |
City | ATLANTA |
State | GA |
Zip Code | 30306-2618 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831125129 | Sharri Khay Rittenhouse | Nurse Practitioner | 1000 Briarcliff Rd Ne, Atlanta, GA 30306-2618 | 2006-06-25 |
1134500754 | Pruitthealth - Virginia Park, LLC | Skilled Nursing Facility | 1000 Briarcliff Rd Ne, Atlanta, GA 30306-2618 | 2015-06-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750900858 | Jill Driver | Chiropractor | 1390 Lanier Blvd Ne, 1409-a, Atlanta, GA 30306 | 2020-04-09 |
1447737697 | Heather Nicole Vansau | Speech-Language Pathologist | 1272 Stillwood Dr Ne, Atlanta, GA 30306 | 2018-07-20 |
1871095919 | Michelle Ruth Orovitz | Nurse Practitioner | 1140 Briarcliff Rd Ne Apt 1, Atlanta, GA 30306 | 2018-03-05 |
1497261960 | Rockwell Oral and Facial Surgery LLC | Dentist | 675 N. Highland Ave Ne, Suite 100, Atlanta, GA 30306 | 2017-12-20 |
1518414101 | David Alan Sturgess Jr. | Counselor | 696 Courtenay Dr, Ne, Atlanta, GA 30306 | 2016-09-01 |
1952778565 | Kristen Jugs | Speech-Language Pathologist | 609 Virginia Ave Ne Apt 4108, None, Atlanta, GA 30306 | 2015-08-31 |
1962749655 | Robert B Tersak | Pharmacist | 1001 Ponce De Leon Avenue Ne, Atlanta, GA 30306 | 2013-01-15 |
1730434812 | Poonam Bhakta Hurley | Physical Therapist | 842 N Highland Ave Ne Ste Ter, Atlanta, GA 30306 | 2012-07-16 |
1609158963 | Centers for Disease Control and Prevention, Us Public Health Service | Public Health or Welfare | 1600 Clifton Rd, Ms E46, Atlanta, GA 30306 | 2011-09-13 |
1598045965 | April Kooy | Physician Assistant | 1000 Briarcliff Road Ne, Atlanta, GA 30306 | 2011-08-17 |
Find all providers in zip 30306 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417563909 | Josephine Almanzar | Student in an Organized Health Care Education/Training Program | 199 Armour Dr Ne Ste E, Atlanta, GA 30324-3973 | 2020-09-20 |
1013532597 | Ivy Elizabeth Cook | Student in an Organized Health Care Education/Training Program | 3121 Flowers Rd S Apt I, Atlanta, GA 30341-5648 | 2020-06-10 |
1265055495 | Jeffrey Quinn Taylor II | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne # 2300b, Atlanta, GA 30322-1013 | 2020-05-21 |
1073134391 | Robert Shvarts | Student in an Organized Health Care Education/Training Program | 465 Memorial Dr Se Unit 346, Atlanta, GA 30312-2229 | 2020-04-27 |
1477173920 | Ryan William Flanagan | Student in an Organized Health Care Education/Training Program | 2591 Piedmont Rd Ne Apt 1531, Atlanta, GA 30324-6280 | 2020-04-24 |
1467071589 | Charles Thomas Reeder | Student in an Organized Health Care Education/Training Program | 1744 Logans Knl Ne, Atlanta, GA 30329-4100 | 2020-04-09 |
1548899743 | Chandni Patel | Student in an Organized Health Care Education/Training Program | 700 14th St Nw, Atlanta, GA 30318-5408 | 2020-04-08 |
1962031625 | Rachel Reed | Student in an Organized Health Care Education/Training Program | 1364 Clifton Rd Ne Ste H-100, Atlanta, GA 30322-1059 | 2020-04-05 |
1629606264 | Jasmine Donesha Shackelford | Student in an Organized Health Care Education/Training Program | Emory Family Medicine, 4500 North Shallowford Road, Atlanta, GA 30338 | 2020-03-30 |
1467080218 | Aminah Danielle Phelps | Student in an Organized Health Care Education/Training Program | 395 Saint Jacques Ct Sw, Atlanta, GA 30331-8434 | 2020-03-28 |
Find all providers in ATLANTA |
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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.