Active NPI
Chizoba Odimgbe
- Pharmacist
- Port Wentworth, GA
National Provider Identifier
1477182012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH030626
- Practice address
- 18 Raintree Way
Port Wentworth, GA 31407-3605 - Phone
- (912) 237-1681
- NPI assigned
- Apr 6, 2020
- Last updated
- Nov 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH030626 | GA | Primary |
Addresses
Primary practice location
18 Raintree Way
Port Wentworth, GA 31407-3605
Mailing address
18 Raintree Way
Port Wentworth, GA 31407-3605
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Walgreens.com | WALGREEN CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH030626 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1477182012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 RAINTREE WAY",
"city": "PORT WENTWORTH",
"state": "GA",
"postal_code": "314073605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 RAINTREE WAY",
"city": "PORT WENTWORTH",
"state": "GA",
"postal_code": "314073605",
"telephone_number": "912-237-1681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODIMGBE",
"first_name": "CHIZOBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-06",
"last_updated": "2023-11-27",
"certification_date": "2020-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH030626",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Walgreens.com",
"affiliation": "Y",
"affiliationName": "WALGREEN CO",
"address_1": "300 N Slappey Blvd",
"city": "Albany",
"state": "GA",
"country_code": "US",
"postal_code": "317011406",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Port Wentworth, GA
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- Shyanne Atocha Nourse
- Shateria Nunley
- Premise Health of Georgia Medical PC (Shaw Family Health Center Savannah)
- Privi Care Home Healthcare LLC
- Procura Health Management LLC
- Progressive Behavior Consulting LLC
- Pruitthealth - Seaside, LLC (PruittHealth - Seaside)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.