Individual provider Active NPI

Malora Sharay Oglesby

  • Surgery Physician
  • Jefferson, GA
National Provider Identifier
1487120846
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
047612678 Issued in GA
Practice address
472 Conductor CT
Jefferson, GA 30549-3242
Phone
(706) 201-9809
NPI assigned
Oct 23, 2018
Last updated
Oct 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 047612678 GA Primary

Addresses

Primary practice location

472 Conductor CT
Jefferson, GA 30549-3242

Mailing address

472 Conductor CT
Jefferson, GA 30549-3242
Phone (706) 201-9809

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

LicenseStateTypeSpecialty
047612678GAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1487120846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 CONDUCTOR CT",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305493242",
            "telephone_number": "706-201-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 CONDUCTOR CT",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305493242",
            "telephone_number": "706-201-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLESBY",
        "first_name": "MALORA",
        "middle_name": "SHARAY",
        "name_prefix": "Prof.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "047612678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.