Individual provider Active NPI

Okeoma Ogo Chukwu, NP

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1043716137
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN259992 Issued in GA
Practice address
445 Winn Way
Decatur, GA 30030-1707
Phone
(678) 949-0969
NPI assigned
Apr 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 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 RN259992 GA Primary

Addresses

Primary practice location

445 Winn Way
Decatur, GA 30030-1707

Mailing address

3202 Hunter Ridge LN
Peachtree Corners, GA 30092-3746
Phone (678) 949-0969

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
I20190305001761 GA Practitioner - Nurse Practitioner 8224377452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advantage Behavioral Health SystemsGroup PAC ID 1052200599, 33 clinicians

Practice addresses (Care Compare)

250 Bray St
Athens, GA 30601-2203
Phone 70638967891108

Hospital & facility affiliations

  • Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN259992GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Behavioral Health Systems CurrentSince Dec 6, 2021 Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients

Locations

250 Bray St
Athens, GA 30601
Phone (706) 542-9746

240 Mitchell Bridge Rd
Athens, GA 30606
Phone (706) 369-5745

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1043716137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 HUNTER RIDGE LN",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300923746",
            "telephone_number": "678-949-0969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301707",
            "telephone_number": "678-949-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUKWU",
        "first_name": "OKEOMA",
        "middle_name": "OGO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN259992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.