P Praxis·MD
● Active Type 1 · Individual

DR. Modupe Agbeyomi, DNP, FNP-C

Nurse Practitioner·Brookhaven, GA· NPI 1245715903 · Enumerated 2018 · 7 years on NPI
Agbeyomi is 1 of 19 nurse practitioner providers in Brookhaven and 1 of 8826 in Georgia.
NPI age
7 years
Enumerated 2018-09-28
Primary specialty
Nurse Practitioner
Plus 5 subspecialties
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2023-11-29
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 8826 active nurse practitioner providers in Georgia.

NPI age
7 years
≈ at median (7 yr)
State licenses
1 state
8% of peers hold multiple states
Subspecialties
5
In the 20% of peers with subspecialties

NPI lifetime · 2018 → 2026

2018-09Enumerated in NPPES
2018 2026

Where they practice

Practice location
13 Corporate Blvd Ne Ste 200
Brookhaven, GA 303291900
📞 7705571079fax 7708726621
Mailing address
13 Corporate Blvd Ne Ste 200
Brookhaven, GA 303291900
📞 7705571079fax 7708726621

Specialties

  • Nurse Practitioner Primary
    Definition to come...
    GA license #F09180151 taxonomy 363LF0000X
  • Clinic/Center
    Definition to come...
    taxonomy 261QI0500X
  • Clinic/Center
    Definition to come...
    taxonomy 261QM1000X
  • Home Infusion
    Definition to come...
    taxonomy 251F00000X
  • Nurse Practitioner
    Definition to come...
    GA license #F09180151 taxonomy 363LP2300X
  • Nurse Practitioner
    Definition to come...
    GA license #F09180151 taxonomy 363LS0200X

Identifiers

TypeValueNotes
05 (GA) F09180151

Practice context

Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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