NPIMap

Individual provider Active NPI

Leo Ovadje, M.D.

  • Nephrology Physician
  • Stockbridge, GA
National Provider Identifier
1386635795
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
055143 Issued in GA
Practice address
105 N Park TRL
Suite 300
Stockbridge, GA 30281-7373
Phone
(678) 284-0800
Fax
(678) 284-0393
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

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

Addresses

Primary practice location

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

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
526707739GMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040831000883 GA Practitioner - NephrologyPractitioner - Internal Medicine 3072427905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Caritas Medical CenterGroup PAC ID 7012183478, 5 clinicians

Practice addresses (Care Compare)

105 N Park Trail
Suite 300
Stockbridge, GA 30281-7432
Phone (678) 284-0800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35009TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Caritas Medical Center Nephrology CurrentSince Dec 1, 2011 Accepting new patients
Caritas Medical Center Fayetteville LLC Nephrology Current Accepting new patients
Rai Care Centers of Stockbridge, LLC PastSince Jul 27, 2010 Accepting new patients
Decatur County General Hospital Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients
Pathways of Tennessee, Inc. Past Accepting new patients
Firstcare Medical Center, PC Past Accepting new patients

Locations

105 Northpark Trl
Ste 300
Stockbridge, GA 30281
Phone (678) 284-0800

Interoperability endpoints

  • Direct secure messaging: leo.ovadje@caritasmed.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GCGCAA/Endpoint/GCGCAA

Organizations & group practices 8

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386635795",
    "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": "SUITE 300",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817373",
            "telephone_number": "678-284-0800",
            "fax_number": "678-284-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVADJE",
        "first_name": "LEO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "055143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "526707739G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.