Individual provider Active NPI

Ubi Okim

  • Psychiatric/Mental Health Nurse Practitioner
  • Villa Rica, GA
National Provider Identifier
1063233104
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-NP152608 Issued in GA
Practice address
20 Herrell Rd
Villa Rica, GA 30180
Phone
(770) 812-3530
Fax
(770) 812-3531
NPI assigned
Oct 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-NP152608 GA Primary

Addresses

Primary practice location

20 Herrell Rd
Villa Rica, GA 30180

Mailing address

20 Herrell Rd
Villa Rica, GA 30180-5527
Phone (770) 812-3530

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
I20250917003064 GA Practitioner - Nurse Practitioner 9436653060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Greenway Blvd
Carrollton, GA 30117-4338

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-NP152608GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMC-Behavioral Health of West Georgia CurrentSince Oct 1, 2025 Accepting new patients

Locations

100 Greenway Blvd
Ste C
Carrollton, GA 30117
Phone (770) 838-8710

101 Quartz Dr
Ste 103A
Villa Rica, GA 30180
Phone (770) 456-3266

101 Quartz Dr
Ste 103B
Villa Rica, GA 30180
Phone (770) 812-3580

Organizations & group practices 1

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": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1063233104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HERRELL RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301805527",
            "telephone_number": "770-812-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HERRELL RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "30180",
            "telephone_number": "770-812-3530",
            "fax_number": "770-812-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKIM",
        "first_name": "UBI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-22",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP152608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.