Individual provider Active NPI

Jude Ogho Okugbeni, M.D.

  • Family Medicine Physician
  • Fitzgerald, GA
National Provider Identifier
1407865389
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
049543 Issued in GA
Practice address
407 West Pine
Fitzgerald, GA 31750
Phone
(770) 279-0732
NPI assigned
Aug 7, 2006
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
Family Medicine Physician 207Q00000X 049543 GA Primary

Addresses

Primary practice location

407 West Pine
Fitzgerald, GA 31750

Mailing address

407 West Pine
Fitzgerald, GA 31750

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
I20140407001487 GA Practitioner - Pediatric Medicine 5597714261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Howard University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sandy Springs Family Medicine and Urgent CareGroup PAC ID 8628208097, 2 clinicians

Practice addresses (Care Compare)

8640 Roswell Rd
Sandy Springs, GA 30350-1821
Phone (770) 696-2697

National Provider Directory

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

Organizations & group practices 1

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407865389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 WEST PINE",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "31750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 WEST PINE",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "31750",
            "telephone_number": "770-279-0732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUGBENI",
        "first_name": "JUDE",
        "middle_name": "OGHO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "049543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitzgerald, GA

Sources for this page

Verify at the official NPI Registry.