Individual provider Active NPI

Beatrix Ohienmhen, MD

  • Pediatrics Physician
  • Woodstock, GA
National Provider Identifier
1447646534
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
82981 Issued in GA
Practice address
900 Towne Lake Pkwy Ste 306
Woodstock, GA 30189-1604
Phone
(770) 852-7720
Fax
(770) 852-7721
NPI assigned
Apr 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 82981 GA Primary
Pediatrics Physician 208000000X D0085509 MD

Addresses

Primary practice location

900 Towne Lake Pkwy Ste 306
Woodstock, GA 30189-1604

Mailing address

11315 Pembrooke SQ Ste 110
Waldorf, MD 20603-4806
Phone (301) 843-6996

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
I20190925002136 GA Practitioner - Pediatric Medicine 4981905379 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0085509MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services, LLC CurrentSince Aug 14, 2019 Accepting new patients
Northside Primary Care Professional Services,LLC Current Accepting new patients

Locations

684 Sixes Rd
Ste 220
Holly Springs, GA 30115
Phone (678) 313-5914

684 Sixes Rd
Ste 130
Holly Springs, GA 30115
Phone (678) 388-5485

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

900 Towne Lake Pkwy
Ste 306
Woodstock, GA 30189
Phone (770) 852-7720

Organizations & group practices 2

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": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1447646534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11315 PEMBROOKE SQ STE 110",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034806",
            "telephone_number": "301-843-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TOWNE LAKE PKWY STE 306",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301891604",
            "telephone_number": "770-852-7720",
            "fax_number": "770-852-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHIENMHEN",
        "first_name": "BEATRIX",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "82981",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0085509",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.