Enoch Kotei, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

73541 Issued in GA

Practice address

2084 Headland Dr
East Point, GA 30344

Phone

(404) 965-5691

Fax

(404) 698-1478

NPI assigned

Apr 4, 2013

Last updated

Oct 22, 2019By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southside Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1235123993
  Medicare reassignment NPD
• PMR Georgia Holding, LLC

  dba Jencare Neighborhood Medical Center

  • Specialist
  • Miami Gardens, FL
  • NPI 1609329630

  GA

  Medicare reassignment NPD
• Jencare Neighborhood Medical Center Morrow, LLC

  • Specialist
  • Morrow, GA
  • NPI 1336571868
  NPD
• Southside Medical Center, Inc

  dba Southside Medical Center School Based Health Center at Lee Elementary School

  • Federally Qualified Health Center (FQHC)
  • Jonesboro, GA
  • NPI 1821981234
  NPD
• Jencare Neighborhood Medical Center West End, LLC

  • Specialist
  • Atlanta, GA
  • NPI 1366783524
  NPD (past)

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1205179512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2084 HEADLAND DR",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "30344",
            "telephone_number": "404-965-5691",
            "fax_number": "404-698-1478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1364 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221059",
            "country_code": "US",
            "telephone_number": "404-727-7050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1364 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221059",
            "country_code": "US",
            "telephone_number": "404-727-7050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTEI",
        "first_name": "ENOCH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "73541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Kendrick
• Jaime Kim, DDS
• Sharon Diane King, NP-C
• Kingsley Agbeyegbe MD
• Kisha Carter DMD PC (BLUSH Dental Studio)
• Andy Lafontant, PA-C
• Djennie Lajeunesse
• Sharay D Lane, SLP
• Demetrius R Lemon
• Andre Terrell Lenoir, O.D

• Internal Medicine Physician in East Point, GA
• Providers in East Point, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.