Individual provider Active NPI

Nwamaka Anwuli Ngoddy, O.D.

  • Optometrist
  • East Point, GA
National Provider Identifier
1427309871
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002706 Issued in GA
Practice address
844 Cleveland Ave
East Point, GA 30344-2900
Phone
(404) 460-6163
NPI assigned
Sep 25, 2012
Last updated
Feb 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002706 GA Primary

Addresses

Primary practice location

844 Cleveland Ave
East Point, GA 30344-2900

Mailing address

5896 Blacktop Way
Fairburn, GA 30213-4418
Phone (678) 697-8503

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131010000969 GA Practitioner - Optometry 3779717582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

844 Cleveland Ave
East Point, GA 30344-2900

844 Cleveland Ave SW
East Point, GA 30344-2907
Phone (404) 460-6163

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Totally Care LLC Optometrist CurrentSince Jul 27, 2013 Accepting new patients

Locations

844 Cleveland Ave
East Point, GA 30344
Phone (404) 460-6160

7325 Jonesboro Rd
Morrow, GA 30260
Phone (678) 422-4854

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1427309871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5896 BLACKTOP WAY",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302134418",
            "telephone_number": "678-697-8503",
            "fax_number": "404-765-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 CLEVELAND AVE",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303442900",
            "telephone_number": "404-460-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGODDY",
        "first_name": "NWAMAKA",
        "middle_name": "ANWULI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-25",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, GA

Sources for this page

Verify at the official NPI Registry.