Individual provider Active NPI

Agwu O Onuoha, M.D.

  • Internal Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1699700047
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
046896 Issued in GA
Practice address
1970 Riverside Pkwy
Lawrenceville, GA 30043-5937
Phone
(404) 321-6111
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 046896 GA Primary

Addresses

Primary practice location

1970 Riverside Pkwy
Lawrenceville, GA 30043-5937

Mailing address

2716 Ivy Bluff CT
Buford, GA 30519-7911
Phone (404) 435-6217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051011000091 GA Practitioner - Internal Medicine 0941225866 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Behavioral Health & Developmental Disabilities, Ga CurrentSince Feb 12, 2010 Accepting new patients
Department of Behavioral Health and Developmental Disabilities Current Accepting new patients
Department of Behavioral Health and Developmental Disabilities CurrentSince Feb 12, 2010 Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Internal Medicine Past Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients

Locations

3405 Old Savannah Rd
Augusta, GA 30906
Phone (705) 790-2030

3073 Panthersville Rd
Decatur, GA 30034
Phone (404) 243-2100

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699700047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 IVY BLUFF CT",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305197911",
            "telephone_number": "404-435-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 RIVERSIDE PKWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435937",
            "telephone_number": "404-321-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONUOHA",
        "first_name": "AGWU",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "046896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.