NPIMap

Individual provider Active NPI

Magnus Ojukwu

  • Physician Assistant
  • Stockbridge, GA
National Provider Identifier
1326699539
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9886 Issued in GA
Practice address
1365 Rock Quarry Rd Ste 300
Stockbridge, GA 30281-5024
Phone
(678) 206-2424
NPI assigned
Sep 28, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X 530131 GA
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 9886 GA Primary

Addresses

Primary practice location

1365 Rock Quarry Rd Ste 300
Stockbridge, GA 30281-5024

Mailing address

1217 McPherson LN Apt a
Norcross, GA 30093-4255
Phone (501) 626-6212

Other practice location 1

1217 McPherson Ln Apt A
Norcross, GA 30093-4255
Phone (501) 626-6212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
530131GAMDRadiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
ENT of Georgia, LLC Past Accepting new patients
Milton Hall Surgery Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1569628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1326699539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 MCPHERSON LN APT A",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300934255",
            "telephone_number": "501-626-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 ROCK QUARRY RD STE 300",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815024",
            "telephone_number": "678-206-2424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1217 McPherson Ln Apt A",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300934255",
            "country_code": "US",
            "telephone_number": "501-626-6212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OJUKWU",
        "first_name": "MAGNUS",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-28",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "GA",
            "license": "530131",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9886",
            "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 Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.