Moronke Ogundele, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT012084 Issued in GA

Practice address

335 Upper Riverdale Rd Ste B10
Jonesboro, GA 30236-1071

Phone

(770) 907-5743

NPI assigned

Aug 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • Lilburn, GA
  • NPI 1760568257
  Medicare reassignment NPD
• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1003282526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 UPPER RIVERDALE RD STE B10",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361071",
            "telephone_number": "770-907-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 UPPER RIVERDALE RD STE B10",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361071",
            "telephone_number": "770-907-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNDELE",
        "first_name": "MORONKE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oasis Homecare Solutions LLC
• Eucharia Udoka Obi, FNP
• Faith Obi
• Taiwo Olushola Odedeyi, M.D
• Kristy Odom
• Angela Nkoli Okafor, PT
• Taisha K Okafor, MD
• Evaristus O Okogie, DMD
• Jessica Okoli, NP
• Winnie Kenyanya Olemusa

• Physical Therapist in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.