Individual provider Active NPI

Okezie Chimuanya Onuoha, PT, DPT

  • Physical Therapist
  • Stockbridge, GA
National Provider Identifier
1609320001
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT013651 Issued in GA
Practice address
1240 Eagle Lndng Pkwy Ste 300
Stockbridge, GA 30281-5173
Phone
(770) 506-4350
NPI assigned
Aug 15, 2016
Last updated
Oct 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 26412 MD
Student in an Organized Health Care Education/Training Program 390200000X 626156 DC
Physical Therapist 225100000X PT013651 GA Primary

Addresses

Primary practice location

1240 Eagle Lndng Pkwy Ste 300
Stockbridge, GA 30281-5173

Mailing address

900 Circle 75 Pkwy SE Ste 1700
Atlanta, GA 30339-3087
Phone (678) 996-7230

Other practice location 1

930 E Swan Creek Rd
Ft Washington, MD 20744-5250
Phone (301) 292-9400

Other practice location 2

7130 Mount Zion Blvd Ste 9
Jonesboro, GA 30236-2566
Phone (770) 603-5660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190204000026 GA Practitioner - Physical Therapist in Private Practice 5991072712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

918 Dailey Mill Rd
McDonough, GA 30253-5469
Phone (678) 532-7754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26412MDMDPhysical Therapist
626156DCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Expert Doctors of Physical Therapy Physical Therapist CurrentSince Feb 17, 2023 Accepting new patients

Locations

255 Racetrack Rd
McDonough, GA 30252
Phone (478) 696-2028

918 Dailey Mill Rd
McDonough, GA 30253
Phone (678) 532-7754

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": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1609320001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY SE STE 1700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393087",
            "telephone_number": "678-996-7230",
            "fax_number": "708-180-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 EAGLE LNDNG PKWY STE 300",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815173",
            "telephone_number": "770-506-4350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 E Swan Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Ft Washington",
            "state": "MD",
            "postal_code": "207445250",
            "country_code": "US",
            "telephone_number": "301-292-9400",
            "fax_number": "301-292-9404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7130 Mount Zion Blvd Ste 9",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "GA",
            "postal_code": "302362566",
            "country_code": "US",
            "telephone_number": "770-603-5660",
            "fax_number": "770-603-6779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONUOHA",
        "first_name": "OKEZIE",
        "middle_name": "CHIMUANYA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-15",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26412",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "DC",
            "license": "626156",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.