Individual provider Active NPI

Uzoamaka P Okonkwo

  • Family Nurse Practitioner
  • Lagrange, GA
National Provider Identifier
1003790551
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN310199 Issued in GA
Practice address
1400 Hogansville Rd
Lagrange, GA 30241-1422
Phone
(706) 803-7390
NPI assigned
Aug 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN310199 GA Primary
Primary Care Nurse Practitioner 363LP2300X RN310199 GA
Women's Health Nurse Practitioner 363LW0102X RN310199 GA

Addresses

Primary practice location

1400 Hogansville Rd
Lagrange, GA 30241-1422

Mailing address

PO Box 56
Dallas, GA 30132-0001
Phone (404) 707-0304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251003002573 GA Practitioner - Nurse Practitioner 0244736635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

114 Crescent Woode Waay
Dallas, GA 30157-5711

114 Crescent Woode Way
Dallas, GA 30157-5711

795 Powder Springs St
Marietta, GA 30064-3689

831 Bedford Ave
Suite 530
Brooklyn, NY 11205-2801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN310199GAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regenerative Wound Solutions PC CurrentSince Jul 24, 2025 Accepting new patients
Anna Chos LLC Family CurrentSince Dec 10, 2025 Accepting new patients

Locations

2850 Springdale Rd SW
Atlanta, GA 30315
Phone (404) 616-8100

795 Powder Springs St
Marietta, GA 30064
Phone (404) 707-0304

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1003790551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301320001",
            "telephone_number": "404-707-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HOGANSVILLE RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302411422",
            "telephone_number": "706-803-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKONKWO",
        "first_name": "UZOAMAKA",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN310199",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN310199",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN310199",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.