Individual provider Active NPI

Kenneth Onyekwere Ofoha, M.D.

  • Emergency Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1154681567
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
68463 Issued in GA
Practice address
905 Parkside Walk LN Ste 100a
Lawrenceville, GA 30043-7314
Phone
(678) 442-9486
NPI assigned
May 18, 2012
Last updated
Mar 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 68463 GA Primary

Addresses

Primary practice location

905 Parkside Walk LN Ste 100a
Lawrenceville, GA 30043-7314

Mailing address

PO Box 492110
Lawrenceville, GA 30049-0036
Phone (678) 442-9486

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
I20130524000450 GA Practitioner - Emergency Medicine 5597903088 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 922-4281

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68463GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Emergency Group, LLC Emergency Medicine Current Accepting new patients
KL Medical Clinic, LLC. Current Accepting new patients
Houston County Emergency Group, LLC Emergency Medicine CurrentSince Mar 20, 2023 Accepting new patients
Emerginet SRMC, LLC CurrentSince Apr 1, 2013 Accepting new patients
Peach Emergency Group LLC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
Georgia Emergency Group, LLC Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Lavender Inpatient Services LLC Past Accepting new patients

Locations

1960 Highway 247
Byron, GA 31008
Phone (478) 654-2000

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

1050 McDonough Rd
Jackson, GA 30233
Phone (770) 775-7861

905 Parkside Walk Ln
Ste 100A
Lawrenceville, GA 30043
Phone (678) 442-9486

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

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

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 7

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 2

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": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1154681567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 492110",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300490036",
            "telephone_number": "678-442-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 PARKSIDE WALK LN STE 100A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437314",
            "telephone_number": "678-442-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFOHA",
        "first_name": "KENNETH",
        "middle_name": "ONYEKWERE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-18",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "68463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.