Individual provider Active NPI

Alphonse Okechukwu Okibedi Jr., PHARM. D

  • Pharmacist
  • Mableton, GA
National Provider Identifier
1164705091
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH024723 Issued in GA
Practice address
5000 Floyd Rd SW
M
Mableton, GA 30126-1608
Phone
(770) 819-9420
NPI assigned
Sep 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH024723 GA Primary

Addresses

Primary practice location

5000 Floyd Rd SW
M
Mableton, GA 30126-1608

Mailing address

2148 Chaseford LN
Powder Springs, GA 30127-5637
Phone (404) 402-2902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH024723GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Star Home Health Care LLC Past Accepting new patients

Organizations & group practices 1

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": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1164705091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2148 CHASEFORD LN",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301275637",
            "telephone_number": "404-402-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 FLOYD RD SW",
            "address_2": "M",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301261608",
            "telephone_number": "770-819-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKIBEDI",
        "first_name": "ALPHONSE",
        "middle_name": "OKECHUKWU",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHARM. D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH024723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mableton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.