Individual provider Active NPI

Chidinma Onyinye Ukadike, MD

  • Pediatrics Physician
  • Conyers, GA
National Provider Identifier
1235711078
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
74576 Issued in TN
Practice address
1478 Dogwood Dr SE
Conyers, GA 30013-5088
Phone
(404) 365-0966
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 111887 GA
Pediatrics Physician 208000000X 111887 GA
Pediatrics Physician 208000000X 74576 TN Primary
Internal Medicine Physician 207R00000X 74576 TN

Addresses

Primary practice location

1478 Dogwood Dr SE
Conyers, GA 30013-5088

Mailing address

1478 Dogwood Dr SE
Conyers, GA 30013-5088
Phone (404) 365-0966

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260512001601 GA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 8527446376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Morehouse School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3495 Piedmont Rd NE BLDG
9 BLDG 9 1St Floor
Atlanta, GA 30305-1736

3495 Piedmont Rd NE BLDG
Suite 91
Atlanta, GA 30305-1717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
74576TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Internal Medicine PastSince Jun 9, 2014 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": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1235711078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1478 DOGWOOD DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300135088",
            "telephone_number": "404-365-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1478 DOGWOOD DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300135088",
            "telephone_number": "404-365-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKADIKE",
        "first_name": "CHIDINMA",
        "middle_name": "ONYINYE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "111887",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "111887",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "74576",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "74576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.