NPIMap

Individual provider Active NPI

Augustine Uchechukwu Obi, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Salisbury, NC
National Provider Identifier
1093719528
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
9400602 Issued in NC
Practice address
611 Mocksville Ave
Salisbury, NC 28144-2705
Phone
(704) 633-7220
Fax
(704) 647-0515
NPI assigned
Jun 13, 2005
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 9400602 NC Primary

Addresses

Primary practice location

611 Mocksville Ave
Salisbury, NC 28144-2705

Mailing address

611 Mocksville Ave
Salisbury, NC 28144-2705
Phone (704) 633-7220

Other practice location 1

143 Joe Knox Ave
Suite 100
Mooresville, NC 28117-9243
Phone (704) 664-2910

Other practice location 2

143 Joe Knox Ave
Suite 100
Mooresville, NC 28117-9243
Phone (704) 664-2910

Other identifiers 1

IdentifierTypeStateIssuer
8963531MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SD, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060616000219 NC Practitioner - EndocrinologyPractitioner - Internal Medicine 4880606672 Reassigns benefits to 1 organization
I20110817000339 SD Practitioner - EndocrinologyPractitioner - Internal Medicine 4880606672 Reassigns benefits to 1 organization
I20190225002413 MN Practitioner - Endocrinology 4880606672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1200 6TH Ave N
Saint Cloud, MN 56303-2735

1200 6TH N Ave
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

1555 Northway Dr
100 Centra Care Clinic Northway Family
St Cloud, MN 56303-1258
Phone (320) 251-1775

1900 Centracare Cir
Saint Cloud, MN 56303-5000

PO Box
Chicago, IL 60673

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Current Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Jun 20, 2016 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Centracare Clinic CurrentSince Jan 29, 2020 Accepting new patients
24 On Physicians, P.C. CurrentSince May 4, 2015 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Jun 20, 2016 Accepting new patients
24 On Physicians, P.C. CurrentSince May 4, 2015 Accepting new patients
Trinity Health Care PA PastSince Feb 1, 1999 Accepting new patients
Fryecare Physicians , LLC Past Accepting new patients
Fryecare Physicians , LLC Past Accepting new patients

Locations

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1900 Centracare Cir
Ste 2500
Saint Cloud, MN 56303
Phone (230) 229-5000

3990 US Highway 64 E
Murphy, NC 28906
Phone (828) 837-5939

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

Interoperability endpoints

  • Direct secure messaging: aobi460869@direct.centracare.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1093719528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 MOCKSVILLE AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442705",
            "telephone_number": "704-633-7220",
            "fax_number": "704-647-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 MOCKSVILLE AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442705",
            "telephone_number": "704-633-7220",
            "fax_number": "704-647-0515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "143 Joe Knox Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281179243",
            "country_code": "US",
            "telephone_number": "704-664-2910",
            "fax_number": "704-664-2936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "143 Joe Knox Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281179243",
            "country_code": "US",
            "telephone_number": "704-664-2910",
            "fax_number": "704-664-2936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBI",
        "first_name": "AUGUSTINE",
        "middle_name": "UCHECHUKWU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "9400602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8963531",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.