NPIMap

Organization Active NPI

Star Family Healthcare and Wellness Center LLC

  • Family Nurse Practitioner
  • College Park, GA
National Provider Identifier
1083958623
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN145805 Issued in GA
Legal business name
STAR FAMILY HEALTHCARE AND WELLNESS CENTER LLC
Practice address
5337 Old National Hwy
Suite 100
College Park, GA 30349-3208
Phone
(404) 767-7777
Fax
(404) 767-7770
NPI assigned
Nov 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Authorized official

Name
Dr. Helen Onyedikachi Uzokwe, DNP, FMPNPI 1306018445
Title
Owner
Phone
(404) 767-7777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X RN145805 GA Primary

Addresses

Primary practice location

5337 Old National Hwy
Suite 100
College Park, GA 30349-3208

Mailing address

5337 Old National Hwy
Suite 100
College Park, GA 30349-3208
Phone (404) 767-7777

Other identifiers 1

IdentifierTypeStateIssuer
617170200MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130221000176 GA Part B Supplier - Clinic/Group Practice 5799930814 Receives reassigned benefits from 1 practitioner
Practice locations: College Park, GA; Griffin, GA; Riverdale, GA

National Provider Directory

National Provider Directory
Tax ID family
Star Fam Healthcare Wellness2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1083958623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5337 OLD NATIONAL HWY",
            "address_2": "SUITE 100",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493208",
            "telephone_number": "404-767-7777",
            "fax_number": "404-767-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5337 OLD NATIONAL HWY",
            "address_2": "SUITE 100",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493208",
            "telephone_number": "404-767-7777",
            "fax_number": "404-767-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR FAMILY HEALTHCARE AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "UZOKWE",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "ONYEDIKACHI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-767-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, FMP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN145805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "617170200",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.