NPIMap

Organization Active NPI

Caritas Medical Center

  • Nephrology Physician
  • Stockbridge, GA
National Provider Identifier
1245390681
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
055143 Issued in GA
Legal business name
CARITAS MEDICAL CENTER
Practice address
105 N Park TRL
Ste 300
Stockbridge, GA 30281-7373
Phone
(678) 284-0800
Fax
(678) 284-0393
NPI assigned
Dec 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Leo O OvadjeNPI 1386635795
Title
Physician and Owner
Phone
(678) 284-0800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 055143 GA Primary

Addresses

Primary practice location

105 N Park TRL
Ste 300
Stockbridge, GA 30281-7373

Mailing address

PO Box 2130
Stockbridge, GA 30281-8909
Phone (678) 284-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120105000932 GA Part B Supplier - Clinic/Group Practice 7012183478 Receives reassigned benefits from 7 practitioners
Practice locations: Atlanta, GA; Locust Grove, GA; Riverdale, GA; Stockbridge, GA

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245390681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2130",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302818909",
            "telephone_number": "678-284-0800",
            "fax_number": "678-284-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N PARK TRL",
            "address_2": "STE 300",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817373",
            "telephone_number": "678-284-0800",
            "fax_number": "678-284-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARITAS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OVADJE",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PHYSICIAN AND OWNER",
        "authorized_official_telephone_number": "678-284-0800",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "055143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.