Active NPI
Ike Okoli, RPH
- Pharmacist
- Lawrenceville, GA
National Provider Identifier
1629672696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH025337
- Practice address
- 620 W Pike St
Lawrenceville, GA 30046-7699 - Phone
- (770) 339-1801
- NPI assigned
- Nov 30, 2020
- Sex
- Male
- 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 | RPH025337 | GA | Primary |
Addresses
Primary practice location
620 W Pike St
Lawrenceville, GA 30046-7699
Mailing address
11405 Mabrypark PL
Alpharetta, GA 30022-7361
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RPH025337 | Other | GA | STATE LICENSE NUMBER |
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH025337 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy L.L.C | Past | Accepting new patients |
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": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1629672696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11405 MABRYPARK PL",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300227361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 W PIKE ST",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300467699",
"telephone_number": "770-339-1801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKOLI",
"first_name": "IKE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH025337",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "RPH025337",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.