Active NPI
Kitefre Okitefre Oboho, MD
- Family Medicine Physician
- Atlanta, GA
National Provider Identifier
1356385181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 054847
- Practice address
- 1701 Hardee Avenue SW
VA Fort McPherson Clinic
Atlanta, GA 30310 - Phone
- (678) 232-6619
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 054847 | GA | Primary |
Addresses
Primary practice location
1701 Hardee Avenue SW
VA Fort McPherson Clinic
Atlanta, GA 30310
Mailing address
614 Summers LNDG SW
Atlanta, GA 30331-7709
Phone (404) 346-1477
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070301000480 | GA | Practitioner - Family Practice | 1658370556 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 86.46 of 100
- Quality
- 71.9
- Improvement activities
- 40
- Cost
- 87.09
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054847 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Emergency Services, Inc. | Current | Accepting new patients | |
| Jenkins County Hospital LLC | Past | Accepting new patients | |
| Nes Georgia, Inc. | Past | Accepting new patients | |
| Screven County Family Health Center, LLC | Family Medicine | Past | Accepting new patients |
| Tattnall Emergency Physicians, LLC | Past | Accepting new patients |
Locations
2855 Old Highway 5
Blue Ridge, GA 30513
Phone (706) 632-4263
5995 Spring St
Warm Springs, GA 31830
Phone (706) 632-4374
Organizations & group practices 5
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.
-
- Critical Access Hospital
- Millen, GA
- NPI 1497064679
-
- Emergency Medicine Physician
- Hazlehurst, GA
- NPI 1144201559
-
- Rural Health Clinic/Center
- Sylvania, GA
- NPI 1841432044
Family Medicine
-
- Emergency Medicine Physician
- Reidsville, GA
- NPI 1679520217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484092800000",
"number": "1356385181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 SUMMERS LNDG SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303317709",
"telephone_number": "404-346-1477",
"fax_number": "404-346-0798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 HARDEE AVENUE SW",
"address_2": "VA FORT MCPHERSON CLINIC",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30310",
"telephone_number": "678-232-6619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBOHO",
"first_name": "KITEFRE",
"middle_name": "OKITEFRE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2017-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "054847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.