Individual provider Active NPI

Okechukwu Nnaji, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1619459542
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201876 Issued in GA
Practice address
445 Winn Way
Decatur, GA 30030-1707
Phone
(404) 294-3745
NPI assigned
Sep 6, 2018
Last updated
Oct 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201876 GA Primary

Addresses

Primary practice location

445 Winn Way
Decatur, GA 30030-1707

Mailing address

8431 Browns Mill Trce
Lithonia, GA 30038-7509
Phone (770) 841-4763

Other practice location 1

8431 Browns Mill Trce
Lithonia, GA 30038-7509
Phone (770) 841-4763

Other identifiers 1

IdentifierTypeStateIssuer
RN201876OtherGANP NUMBER

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190611002737 GA Practitioner - Nurse Practitioner 4284967910 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201876GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Community Service Board CurrentSince Sep 15, 2019 Accepting new patients
Lithonia Behavioral Health Inc Psychiatric/Mental Health Current Accepting new patients
McIntosh Trail Community Service Board CurrentSince Jan 23, 2019 Accepting new patients
Unitedhands Health & Wellness Clinic LLC CurrentSince Feb 6, 2021 Accepting new patients
McIntosh Trail Community Service Board CurrentSince Jan 23, 2019 Accepting new patients
Cci Transportation Services Inc Current Accepting new patients
Dekalb Community Service Board PastSince Sep 15, 2019 Accepting new patients

Locations

445 Winn Way
Decatur, GA 30030
Phone (404) 294-3745

450 Winn Way
Decatur, GA 30030
Phone (404) 294-3745

455 Winn Way
Decatur, GA 30030
Phone (404) 294-3745

1209 Greenbelt Dr
Griffin, GA 30224
Phone (770) 358-8250

1435 N Expressway
Ste 301
Griffin, GA 30223
Phone (678) 516-5179

1115 Mount Zion Rd
Ste J
Morrow, GA 30260
Phone (404) 883-9140

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22835/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1619459542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8431 BROWNS MILL TRCE",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300387509",
            "telephone_number": "770-841-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301707",
            "telephone_number": "404-294-3745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8431 Browns Mill Trce",
            "address_purpose": "LOCATION",
            "city": "Lithonia",
            "state": "GA",
            "postal_code": "300387509",
            "country_code": "US",
            "telephone_number": "770-841-4763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NNAJI",
        "first_name": "OKECHUKWU",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-06",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "201876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP NUMBER",
            "identifier": "RN201876",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.