NPIMap

Individual provider Active NPI

Victor Ezinna Okeh, M.D.

  • Internal Medicine Physician
  • Riverdale, GA
National Provider Identifier
1104092048
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
071268 Issued in GA
Practice address
483 Upper Riverdale Rd SW Ste F
Riverdale, GA 30274
Phone
(770) 742-3883
Fax
(855) 597-8504
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 071268 GA Primary
Internal Medicine Physician 207R00000X ME109619 FL

Addresses

Primary practice location

483 Upper Riverdale Rd SW Ste F
Riverdale, GA 30274

Mailing address

483 Upper Riverdale Rd SW Ste F
Riverdale, GA 30274-2579
Phone (770) 742-3883

Other identifiers 1

IdentifierTypeStateIssuer
ME109619OtherFLMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160712000381 GA Practitioner - Internal Medicine 4486828274 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Regional Physicians Management Group, LLCGroup PAC ID 9032491956, 27 clinicians
Covenant Medical Group LLCGroup PAC ID 4082969241, 17 clinicians

Practice addresses (Care Compare)

11 Upper Riverdale Rd SW
Riverdale, GA 30274-2615
Phone (770) 897-7874

371 E Paces Ferry Rd
Suite 640
Atlanta, GA 30305-2372
Phone (508) 315-2769

483 Upper Riverdale Rd SW
Suite L
Riverdale, GA 30274-2579
Phone (770) 742-3883

Hospital & facility affiliations

  • Pruitthealth Hospice-Macon Hospice, Macon, GA, CCN 111545
  • Southern Regional Medical Center Hospital, Riverdale, GA, CCN 110165
  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079
  • Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078
  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Select Specialty Hospital - Midtown Atlanta, LLC Long-term care hospital, Atlanta, GA, CCN 112004
  • Douglasville Center for Nursing and Healing LLC Nursing home, Douglasville, GA, CCN 115273
  • Pruitthealth - Macon Nursing home, Macon, GA, CCN 115288

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME109619FLMDInternal Medicine Physician
071268GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Biocare Oncology and Therapeutics, LLC CurrentSince Jun 10, 2023 Accepting new patients
Covenant Medical Group LLC CurrentSince May 26, 2018 Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince May 11, 2016 Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince May 11, 2016 Accepting new patients
Southern Regional Physicians Management Group, LLC CurrentSince Aug 2, 2017 Accepting new patients
Douglasville Nursing and Rehabilitation Center, LLC Past Accepting new patients
Allatoona Emergency Group PC Past Accepting new patients
Prime Healthcare Foundation - Southern Regional, LLC Past Accepting new patients
East Florida Hospitalists LLC Past Accepting new patients
Kroger Co Past Accepting new patients
Select Specialty Hospital Midtown Atlanta LLC Past Accepting new patients
Pruitthealth - Macon, LLC Past Accepting new patients
Allatoona Physician Services PC Past Accepting new patients
Cape Coral Hospitalists Inc Internal Medicine Past Accepting new patients

Locations

371 E Paces Ferry Rd NE
Ste 640
Atlanta, GA 30305
Phone (470) 377-6400

2360 Rockmart Hwy
Cedartown, GA 30125
Phone (770) 748-2500

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

11 Upper Riverdale Rd SW
Ste 21
Riverdale, GA 30274

483 Upper Riverdale Rd SW
Ste L
Riverdale, GA 30274
Phone (770) 742-3883

Interoperability endpoints

  • Direct secure messaging: ms_vokeh@landmarkhealth-direct.org
  • Direct secure messaging: ms_vokeh1@landmarkhealth-direct.org
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1104092048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 UPPER RIVERDALE RD SW STE F",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742579",
            "telephone_number": "770-742-3883",
            "fax_number": "855-597-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 UPPER RIVERDALE RD SW STE F",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "30274",
            "telephone_number": "770-742-3883",
            "fax_number": "855-597-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEH",
        "first_name": "VICTOR",
        "middle_name": "EZINNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "071268",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME109619",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME109619",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

Verify at the official NPI Registry.