Individual provider Active NPI

Obiageli Okoli

  • Nurse Practitioner
  • Garner, NC
National Provider Identifier
1083384804
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
OKOL-TPJLY Issued in NC
Practice address
1140 Benson Rd Ste 201
Garner, NC 27529-4659
Phone
(862) 224-2861
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X OKOL-TPJLY NC Primary

Addresses

Primary practice location

1140 Benson Rd Ste 201
Garner, NC 27529-4659

Mailing address

1140 Benson Rd Ste 201
Garner, NC 27529-4659
Phone (862) 224-2861

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20221206000779 NC Practitioner - Nurse Practitioner 8224407762 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OKOL-TPJLYNCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Medical Center, Incorporated Current Accepting new patients
Goshen Medical Center Incorporated CurrentSince Nov 1, 2022 Accepting new patients
Goshen Medical Center Incorporated Current Accepting new patients
Goshen Medical Center Incorporated CurrentSince Nov 1, 2022 Accepting new patients

Locations

408 Fairview St
Clinton, NC 28328
Phone (910) 596-2400

444 SW Center St
Faison, NC 28341
Phone (910) 267-0421

102 Main St
Ste 1
Kenansville, NC 28349
Phone (910) 275-0195

130 N Center St
Mount Olive, NC 28365
Phone (919) 658-2505

360 E Charity Rd
Rose Hill, NC 28458
Phone (910) 289-3086

110 Eastwood Dr
Wallace, NC 28466
Phone (910) 285-2330

113 S Pine St
Warsaw, NC 28398
Phone (910) 293-7246

Interoperability endpoints

  • Direct secure messaging: ookoli@goshenmedical.cloudcraftdirect.com

Organizations & group practices 4

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1083384804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 BENSON RD STE 201",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294659",
            "telephone_number": "862-224-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 BENSON RD STE 201",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294659",
            "telephone_number": "862-224-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOLI",
        "first_name": "OBIAGELI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "OKOL-TPJLY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

Verify at the official NPI Registry.