Individual provider Active NPI

Nkechi Okechukwu, M.D

  • Pediatrics Physician
  • Gray, GA
National Provider Identifier
1093971616
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
76084 Issued in GA
Practice address
4292 Gray Hwy
Gray, GA 31032-5900
Phone
(478) 986-2500
Fax
(478) 864-1288
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 76084 GA Primary

Addresses

Primary practice location

4292 Gray Hwy
Gray, GA 31032-5900

Mailing address

PO Box 371
Wrightsville, GA 31096-0371
Phone (478) 864-3448

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210226001396 GA Practitioner - Pediatric Medicine 0345415147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston Hospitals IncGroup PAC ID 4284797580, 27 clinicians

Practice addresses (Care Compare)

1118 Ga Hwy 96
Kathleen, GA 31047-2111
Phone (478) 975-6890

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76084GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Hospitals Inc CurrentSince Jan 4, 2021 Accepting new patients
Houston Hospitals Inc CurrentSince Jan 4, 2021 Accepting new patients

Locations

520 GA Highway 247 S
Ste 501
Bonaire, GA 31005
Phone (478) 352-7110

1118 GA Highway 96
Kathleen, GA 31047
Phone (478) 922-4281

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

233 N Houston Rd
Ste 140A
Warner Robins, GA 31093
Phone (478) 923-2843

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.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1093971616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 371",
            "city": "WRIGHTSVILLE",
            "state": "GA",
            "postal_code": "310960371",
            "telephone_number": "478-864-3448",
            "fax_number": "478-864-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4292 GRAY HWY",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310325900",
            "telephone_number": "478-986-2500",
            "fax_number": "478-864-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKECHUKWU",
        "first_name": "NKECHI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "76084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gray, GA

Sources for this page

Verify at the official NPI Registry.