Individual provider Active NPI

Michael Uchenna Okenchi

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1013482553
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN237511 Issued in GA
Practice address
3715 Atlanta St
Atlanta, GA 30337
Phone
(770) 938-1757
NPI assigned
Oct 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN237511 GA Primary

Addresses

Primary practice location

3715 Atlanta St
Atlanta, GA 30337

Mailing address

849 Creek Cove Way
Loganville, GA 30052-8605
Phone (404) 316-1726

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
I20181112001373 GA Practitioner - Nurse Practitioner 1153675012 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Medical Consulting, P.C.Group PAC ID 3678589967, 19 clinicians

Practice addresses (Care Compare)

3715 Northside Pkwy NW
Building 2 100
Atlanta, GA 30327-2822
Phone (770) 938-1757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN237511GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Medical Consulting, P.C. CurrentSince Oct 22, 2018 Accepting new patients

Locations

54 Peachtree Park Dr NE
Atlanta, GA 30309
Phone (404) 351-6041

3715 Northside Pkwy NW
Bldg 2100
Atlanta, GA 30327
Phone (770) 938-1757

3715 Northside Pkwy NW
Ste 2100
Atlanta, GA 30327
Phone (770) 938-1757

4115 Glenwood Rd
Decatur, GA 30032
Phone (404) 284-6414

2787 N Decatur Rd
Decatur, GA 30033
Phone (404) 292-0626

4595 Cantrell Rd
Flowery Branch, GA 30542
Phone (770) 967-2070

1109 Green St
Roswell, GA 30075
Phone (770) 998-1802

1990 Lakeside Pkwy
Ste 170
Tucker, GA 30084
Phone (770) 938-1757

4608 Lawrenceville Hwy
Tucker, GA 30084
Phone (770) 491-9444

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DDCDAA/Endpoint/DDCDAA

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": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1013482553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 CREEK COVE WAY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300528605",
            "telephone_number": "404-316-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 ATLANTA ST",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30337",
            "telephone_number": "770-938-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKENCHI",
        "first_name": "MICHAEL",
        "middle_name": "UCHENNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN237511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.