Individual provider Active NPI

Sonya Okungu, OD

  • Optometrist
  • Kennesaw, GA
National Provider Identifier
1205786175
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3768 Issued in GA
Practice address
1615 Ridenour Blvd NW Ste 201
Kennesaw, GA 30152-4464
Phone
(770) 499-2020
NPI assigned
Jan 30, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3768 GA Primary
Pediatric Optometrist 152WP0200X 3981 TN

Addresses

Primary practice location

1615 Ridenour Blvd NW Ste 201
Kennesaw, GA 30152-4464

Mailing address

1615 Ridenour Blvd NW Ste 201
Kennesaw, GA 30152-4464
Phone (770) 499-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260319002516 TN Practitioner - Optometry 9436633237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1245 Madison Ave
Memphis, TN 38104-2222

2540 Broad Ave
Apt 407
Memphis, TN 38112-2612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3981TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern College of Optometry Optometrist CurrentSince Feb 3, 2026 Accepting new patients
Optimist LLC Optometrist PastSince Mar 7, 2018 Accepting new patients
Eecarman OD PC Optometrist Past Accepting new patients

Locations

1245 Madison Ave
Memphis, TN 38104
Phone (901) 722-3250

1350 Concourse Ave
Ste 264
Memphis, TN 38104
Phone (901) 252-3670

Organizations & group practices 3

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": "1769731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1205786175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 RIDENOUR BLVD NW STE 201",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524464",
            "telephone_number": "770-499-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 RIDENOUR BLVD NW STE 201",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524464",
            "telephone_number": "770-499-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUNGU",
        "first_name": "SONYA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "3768",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TN",
            "license": "3981",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.