Individual provider Active NPI

Kitefre Okitefre Oboho, MD

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1356385181
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
054847 Issued in GA
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

Updated by the provider on Jan 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070301000480 GA Practitioner - Family Practice 1658370556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.46 of 100Reported as group
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

LicenseStateTypeSpecialty
054847GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Emergency Services, Inc. CurrentSince Feb 1, 2014 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.

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

Verify at the official NPI Registry.