Individual provider Active NPI

Onyebuchi Nwaokolo, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Griffin, GA
National Provider Identifier
1639603707
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN216945 Issued in GA
Practice address
1705 Williamson Rd Ste 101
Griffin, GA 30224-5471
Phone
(678) 603-2898
Fax
(678) 603-2086
NPI assigned
Apr 16, 2017
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN216945 GA Primary
Primary Care Nurse Practitioner 363LP2300X RN216945 GA

Addresses

Primary practice location

1705 Williamson Rd Ste 101
Griffin, GA 30224-5471

Mailing address

1705 Williamson Rd Ste 101
Griffin, GA 30224-5471
Phone (678) 603-2898

Other practice location 1

1705 Williamson Rd Ste 101
Griffin, GA 30224-5471
Phone (404) 706-6372

Other practice location 2

1725 Pennsylvania Ave
McDonough, GA 30253-9118
Phone (678) 472-6457

Other practice location 3

1705 Williamson Rd Suite 101
Griffin, GA 30224

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
I20180801002047 GA Practitioner - Nurse Practitioner 7113275538 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN216945GAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Ropheka Medical Center, PC CurrentSince Jun 9, 2018 Accepting new patients
Optimal Mind Psychiatry LLC Psychiatric/Mental Health Current Accepting new patients
Glofusion LLC CurrentSince Jan 19, 2018 Accepting new patients

Locations

500 Lanier Ave W
Ste 103C
Fayetteville, GA 30214

500 Lanier Ave W
Ste C
Fayetteville, GA 30214
Phone (470) 869-2062

1705 Williamson Rd
Griffin, GA 30224
Phone (470) 863-2062

1705 Williamson Rd
Ste 101
Griffin, GA 30224
Phone (404) 218-8934

1505 Pennsylvania Ave
McDonough, GA 30253
Phone (678) 472-6457

217 Medical Way
Riverdale, GA 30274
Phone (770) 991-9227

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20101/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/3a26afd9-920c-4709-8b6b-367ca80f62e3/

Organizations & group practices 4

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": "1492300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1639603707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 WILLIAMSON RD STE 101",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302245471",
            "telephone_number": "678-603-2898",
            "fax_number": "678-603-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 WILLIAMSON RD STE 101",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302245471",
            "telephone_number": "678-603-2898",
            "fax_number": "678-603-2086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 Williamson Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Griffin",
            "state": "GA",
            "postal_code": "302245471",
            "country_code": "US",
            "telephone_number": "404-706-6372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1725 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "McDonough",
            "state": "GA",
            "postal_code": "302539118",
            "country_code": "US",
            "telephone_number": "678-472-6457",
            "fax_number": "678-603-2086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1705 WILLIAMSON RD SUITE 101",
            "address_purpose": "LOCATION",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "30224",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWAOKOLO",
        "first_name": "ONYEBUCHI",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-16",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN216945",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN216945",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.