Dominiq Eric Okoduwa, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

84498 Issued in GA

Practice address

126 US Highway 280 W
Americus, GA 31719-8645

Phone

(299) 924-6011

NPI assigned

Mar 22, 2018

Last updated

Jun 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Internal Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoebe Home Health Home health agency, Albany, GA, CCN 117100
• Phoebe Sumter Medical Center Hospital, Americus, GA, CCN 110044

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment Care Compare group NPD
• Houston Hospitalist Group LLC

  • Hospitalist Physician
  • Warner Robins, GA
  • NPI 1962040147
  Medicare reassignment NPD
• Phoebe Sumter Medical Center, Inc.

  • General Acute Care Hospital
  • Americus, GA
  • NPI 1609001312
  Medicare reassignment NPD
• Houston Hospitalist Group LLC

  • Hospitalist Physician
  • Perry, GA
  • NPI 1831717511
  NPD
• Phoebe Sumter Medical Center, Inc

  dba Phoebe Sumter Ellaville Clinic

  • Rural Health Clinic/Center
  • Ellaville, GA
  • NPI 1376778001
  NPD
• Phoebe Urology

  • Clinic/Center
  • Albany, GA
  • NPI 1356691257
  NPD

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

• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Home Health

  • Home Health Agency
  • Albany, GA
  • NPI 1790766863
  Care Compare affiliation
• Phoebe Sumter Medical Center, Inc.

  • General Acute Care Hospital
  • Americus, GA
  • NPI 1609001312
  Care Compare affiliation

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1437653565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 E JEFFERSON ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317094780",
            "telephone_number": "299-310-5892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 US HIGHWAY 280 W",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317198645",
            "telephone_number": "299-924-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKODUWA",
        "first_name": "DOMINIQ",
        "middle_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "010562",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "84498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nerissa Nesbitt-Boothe
• Khanh Nguyen
• Ngoc M Nguyen, M.D
• Hannah Njoh
• Mary Norwood
• Jill Suzanne Olek, M.D.
• Courtney Oliver
• Rachael Oliver
• Patrick James Omess, MD
• Donna Onley-Harden, MD

• Internal Medicine Physician in Americus, GA
• Providers in Americus, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.