Atlanta Ropheka Medical Center, PC
Organization Active NPI Family Medicine Physician · Riverdale, GA
NPI 1194945832 · NPPES record last updated Feb 19, 2021
Key facts
- NPI
- 1194945832
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 50236 (GA)
- Legal business name
- ATLANTA ROPHEKA MEDICAL CENTER, PC
- Practice address
- 217 Medical Way
Riverdale, GA 30274-2522 - Phone
- (770) 991-9227
- NPI assigned
- Apr 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Onwura Michael Obiekwe
- Title
- Owner
- Phone
- (770) 991-9227
Practitioners 3
-
Andrea Benford, FNP
-
Onyebuchi Nwaokolo, DNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0258023 | Atlanta Ropheka Medical Center | Provider-performed microscopy | Mar 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040715001042 | GA | Part B Supplier - Clinic/Group Practice | 0648259473 |
Receives reassigned benefits from 3 practitioners Practice locations: Riverdale, GA; Union City, GA |
National Provider Directory
Locations
217 Medical Way
Riverdale, GA 30274
Phone (770) 991-9227
6781 Londonderry Way
Ste 3
Union City, GA 30291
Phone (770) 731-2933
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/3a26afd9-920c-4709-8b6b-367ca80f62e3/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 50236 | GA | Yes |
Addresses
Primary practice location
217 Medical Way
Riverdale, GA 30274-2522
Mailing address
217 Medical Way
Riverdale, GA 30274-2522
Phone (770) 991-9227
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00949253B | Medicaid | GA |
Other providers in Riverdale, GA
- Atlanta Detox Center, LLC
- Atlanta Detox Center, LLC
- Atlanta Multi-Specialty Associates, PC
- Atlanta Neuroscience Associates LLC
- Atlanta Orthopedic & Arthroscopy Center, P. C.
- Atlanta South Endoscopy Center LLC
- Cameron Atterberry
- Akinwole A Awujo
- Martin Babayev
- Back-N-4TH Transportation Service, LLC
All providers in Riverdale, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.