Individual provider Active NPI

Grace Isoken Ogala, N.P

  • Family Nurse Practitioner
  • North Augusta, SC
National Provider Identifier
1619208717
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN252611 Issued in GA
Practice address
350 Austin Graybill Rd
North Augusta, SC 29860
Phone
(803) 278-4272
NPI assigned
Jan 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN252611 GA Primary

Addresses

Primary practice location

350 Austin Graybill Rd
North Augusta, SC 29860

Mailing address

2030 Powers Ferry Rd SE Ste 120
Atlanta, GA 30339-5016
Phone (678) 801-2329

Other practice location 1

3708 Bansbury Pl
Hephzibah, GA 30815-7178
Phone (845) 551-0715

Other names 1

  • Grace Isoken Ogala Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190410000065 SC Practitioner - Nurse Practitioner 6507107059
I20210603002202 GA Practitioner - Nurse Practitioner 6507107059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3421 Mike Padgett Hwy
Augusta, GA 30906-3815
Phone (706) 432-4387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN252611GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CSB Community Mental Health Center of East Central Georgia CurrentSince Jan 1, 2023 Accepting new patients

Locations

3421 Old Savannah Rd
Augusta, GA 30906
Phone (706) 432-4387

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1619208717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 POWERS FERRY RD SE STE 120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395016",
            "telephone_number": "678-801-2329",
            "fax_number": "844-249-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 AUSTIN GRAYBILL RD",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "29860",
            "telephone_number": "803-278-4272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3708 Bansbury Pl",
            "address_purpose": "LOCATION",
            "city": "Hephzibah",
            "state": "GA",
            "postal_code": "308157178",
            "country_code": "US",
            "telephone_number": "845-551-0715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGALA",
        "first_name": "GRACE",
        "middle_name": "ISOKEN",
        "name_prefix": "Ms.",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-29",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN252611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "OGALA",
            "middle_name": "ISOKEN",
            "credential": "N.P",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in North Augusta, SC

Sources for this page

Verify at the official NPI Registry.