Samuel Okwudili Oburota

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

2006008191 Issued in GA

Practice address

7001 Peachtree Industrial Blvd Ste 201-B
Norcross, GA 30092-6640

Phone

(770) 209-9998

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• CKCG Healthcare Services,Inc

  • Pediatric Skilled Nursing Facility
  • Norcross, GA
  • NPI 1083796106
  NPD (past) Authorized official

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1174604649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 PEACHTREE INDUSTRIAL BLVD STE 201-B",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300926640",
            "telephone_number": "770-209-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 PEACHTREE INDUSTRIAL BLVD STE 201-B",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300926640",
            "telephone_number": "770-209-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBUROTA",
        "first_name": "SAMUEL",
        "middle_name": "OKWUDILI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "2006008191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayle L Novitske
• Sara Elizabeth Nunning, M.A, CCC-SLP
• Roy Nzurike
• Lauren Sillery Oberg, FNP-C
• Naomi Obialor
• Occupational Health Centers of Georgia PC
• Occupational Health Centers of Georgia PC
• Occupational Health Centers of Georgia PC
• Occupational Health Centers of Georgia PC
• Occupational Health Centers of Georgia, P.C.

• All providers in Norcross, GA
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.