NPIMap

Individual provider Active NPI

Kelechukwu Uzoma Okoro, M.D.

  • Interventional Cardiology Physician
  • Thomasville, GA
National Provider Identifier
1669869152
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
92782 Issued in GA
Practice address
116 Mimosa Dr
Thomasville, GA 31792-6605
Phone
(229) 551-0083
Fax
(229) 584-5570
NPI assigned
Apr 22, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 92782 GA Primary

Addresses

Primary practice location

116 Mimosa Dr
Thomasville, GA 31792-6605

Mailing address

116 Mimosa Dr
Thomasville, GA 31792-6605
Phone (229) 551-0083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240712002629 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 0840507711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
First Coast Cardiovascular Institute, LLCGroup PAC ID 6002803020, 43 clinicians

Practice addresses (Care Compare)

205 Zeagler Dr
Palatka, FL 32177-3888
Phone (386) 325-2836

Hospital & facility affiliations

  • HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179
  • HCA Florida Orange Park Hospital Hospital, Orange Park, FL, CCN 100226
  • HCA Florida Putnam Hospital Hospital, Palatka, FL, CCN 100232
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
92782GAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Coast Cardiovascular Institute LLC CurrentSince Aug 1, 2024 Accepting new patients
Cardiology Consultants of South Georgia, PC Current Accepting new patients
First Coast Cardiovascular Institute, LLC Interventional Cardiology CurrentSince Aug 1, 2024 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Clearwater Cardiovascular and Interventional Consultants MD PA Interventional Cardiology Past Accepting new patients

Locations

3900 University Blvd S
Jacksonville, FL 32216
Phone (904) 222-6656

7011 A C Skinner Pkwy
Ste 160
Jacksonville, FL 32256
Phone (904) 642-0877

905 Beach Blvd
Jax Bch, FL 32250
Phone (904) 241-8300

1681 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 644-0092

1465 Kingsley Ave
Orange Park, FL 32073
Phone (904) 644-0092

205 Zeagler Dr
Palatka, FL 32177
Phone (386) 325-2836

1155 5th St SE
Cairo, GA 39828
Phone (229) 226-3060

Interoperability endpoints

  • Direct secure messaging: kelechukwuokoro@ccsg.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/IEIHCA

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1669869152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926605",
            "telephone_number": "229-551-0083",
            "fax_number": "229-551-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926605",
            "telephone_number": "229-551-0083",
            "fax_number": "229-584-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKORO",
        "first_name": "KELECHUKWU",
        "middle_name": "UZOMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-22",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "92782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.