SHITTU FAMILY PRACTICE LLC
NPI 1194331439
Nurse Practitioner - Family in Fayetteville, GA
About Shittu Family Practice Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHITTU FAMILY PRACTICE LLC (NPI 1194331439) is a healthcare organization registered as a family in Fayetteville, Georgia and active in the NPI registry since September 2020. The organization holds a CLIA Waiver certificate valid through March 23, 2027 and lists Tawa Sitou, Fnp, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shittu Family Practice Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Shittu Family Practice LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 11D2217787
Shittu Family Practice, LLC · Fayetteville, GAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shittu Family Practice LLC's NPI number?
The NPI number for Shittu Family Practice LLC is 1194331439. It was assigned to this organization in the NPPES registry on September 22, 2020.
Where is Shittu Family Practice LLC located?
Shittu Family Practice LLC is located at 213 Banks Rd, Fayetteville, GA 30214. The listed phone number is (770) 629-1917.
What is Shittu Family Practice LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Shittu Family Practice LLC enrolled in Medicare?
Yes. Shittu Family Practice LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shittu Family Practice LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Shittu Family Practice LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Shittu Family Practice LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2217787) is associated with this NPI, valid through March 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Shittu Family Practice LLC accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Shittu Family Practice LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Shittu Family Practice LLC was last updated on October 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shittu Family Practice Llc · NPI 1194331439
Family organization in Fayetteville, Georgia. Organization record, active in the CMS NPPES registry since September 22, 2020.
## Identity
- **NPI:** 1194331439 (Entity type: Organization)
- **Enumerated:** September 22, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Tawa Sitou, FNP
## Practice location
- **Address:** 213 BANKS RD, Fayetteville, GA 30214
- **Phone:** (770) 629-1917
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 26, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1194331439) · Data from the CMS NPPES public registry.