Otis Samuel Powell Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

025814 Issued in GA

Practice address

777 Cleveland Ave SW Ste 500
Atlanta, GA 30315-7115

Phone

(404) 755-2291

Fax

(404) 755-5377

NPI assigned

Jul 20, 2006

Last updated

Nov 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Otis S. Powell Jr. Other name

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

Specialty

Family Practice

Education

Medical College of Georgia School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Neesam Company IncorporatedGroup PAC ID 0547580201, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: otis.powell.1@26481.direct.athenahealth.com
• Direct secure messaging: powell@su-ga.direct.office.nextgen.com

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.

• Neesam Company Incorporated

  dba South Atlanta Area Primary Care

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1376952069
  Medicare reassignment Care Compare group NPD
• Clinch County Hospital Authority

  • Critical Access Hospital
  • Homerville, GA
  • NPI 1861478851
  Medicare reassignment NPD
• Family Wellness Center LLC

  • Community/Behavioral Health Agency
  • Duluth, GA
  • NPI 1225489354
  Medicare reassignment NPD
• Lakewood Medical

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1346701216
  Medicare reassignment NPD
• The Clinic for All / la Clinica de Todos, LLC

  • Primary Care Clinic/Center
  • East Point, GA
  • NPI 1053598284
  Medicare reassignment NPD
• United Healthcare System of Georgia Inc.

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1609612373
  Authorized official Same address or phone
• American Comprehensive Laboratory and Diagnostic Services, Inc

  • Clinical Medical Laboratory
  • Stone Mountain, GA
  • NPI 1922677996
  NPD
• Jenkins County Hospital LLC

  dba Optim Medical Center - Jenkins

  • Critical Access Hospital
  • Millen, GA
  • NPI 1497064679
  NPD (past)
• My Chronic Care Management LLC

  • Durable Medical Equipment & Medical Supplies
  • Marietta, GA
  • NPI 1750907085
  NPD (past)
• Physicians Primary Care Group Inc.

  dba Cascade Primary Care Group

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1295924157
  NPD (past)
• Screven County Family Health Center, LLC

  dba Optim Primary Care - Sylvania

  • Rural Health Clinic/Center
  • Sylvania, GA
  • NPI 1841432044

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kennestone Hospital, Inc.

  dba Wellstar Kennestone Hospital

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1285654301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CLEVELAND AVE SW STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303157115",
            "telephone_number": "404-755-2291",
            "fax_number": "404-755-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CLEVELAND AVE SW STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303157115",
            "telephone_number": "404-755-2291",
            "fax_number": "404-755-5377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2391 Benjamin E Mays Dr SW",
            "address_2": "Second Floor, Suite A",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303113233",
            "country_code": "US",
            "telephone_number": "404-755-2291",
            "fax_number": "404-755-5377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 Highway 42 Ste C",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302814666",
            "country_code": "US",
            "telephone_number": "770-376-7927",
            "fax_number": "770-727-2074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "OTIS",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "025814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00309845G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OTIS",
            "last_name": "POWELL",
            "middle_name": "S.",
            "suffix": "JR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jacqueline Powell
• Jessica Marie Powell, FNP
• Kerith Powell, D.C.
• Kimone Powell
• Lauren Whitney Powell, MD
• Peyton Millar Powell, ED.S.
• Regan Powell
• Roberta Adams Powell, MS OTR/L
• Rometta E Powell, D.D.S.
• Staisha Powell

• Family Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.