NPIMap

Organization Active NPI

Bola Sogade, MD, LLC

  • Physician Assistant
  • Macon, GA
National Provider Identifier
1407114739
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6409 Issued in GA
Legal business name
BOLA SOGADE, MD, LLC
Practice address
639 Hemlock St
Macon, GA 31201-6886
Phone
(478) 745-3014
NPI assigned
Apr 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Authorized official

Name
Bola Sogade, MDNPI 1558455113
Title
Ceo
Phone
(478) 745-3014

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 6409 GA Primary

Addresses

Primary practice location

639 Hemlock St
Macon, GA 31201-6886

Mailing address

639 Hemlock St
Macon, GA 31201-6886
Phone (478) 745-3014

National Provider Directory

National Provider Directory
Tax ID family
Bola Sogade MD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1407114739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016886",
            "telephone_number": "478-745-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016886",
            "telephone_number": "478-745-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLA SOGADE, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "SOGADE",
        "authorized_official_first_name": "BOLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-745-3014",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.