Individual provider Active NPI

Igwebuike Onyekaba, MD

  • Family Medicine Physician
  • Decatur, GA
National Provider Identifier
1699721605
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
039650 Issued in GA
Practice address
3375 Memorial Dr
Decatur, GA 30032-2706
Phone
(470) 355-2340
Fax
(470) 355-2347
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 039650 GA
General Practice Physician 208D00000X 039650 GA
Family Medicine Physician 207Q00000X 039650 GA Primary

Addresses

Primary practice location

3375 Memorial Dr
Decatur, GA 30032-2706

Mailing address

PO Box 957598
Duluth, GA 30095-9527
Phone (470) 355-2340

Other identifiers 4

IdentifierTypeStateIssuer
01045490AOtherININDIANA LICENSE
198714OtherNYNEW YORK LICENSE
01045490BOtherINCSR
25MA06176700OtherNJNEW JERSEY LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040712000889 GA Practitioner - Family PracticePractitioner - Internal MedicinePractitioner - Emergency Medicine 1254233430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3375 Memorial Dr
Decatur, GA 30032-2706
Phone (678) 878-5704

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
039650GAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oscar Medical Center CurrentSince Jul 25, 2014 Accepting new patients
Preferred Emergency Specialists, Inc. Emergency Medicine Past Accepting new patients
Preferred Emergency Specialists, LLC Emergency Medicine Past Accepting new patients
Person Emergency Physicans PA Emergency Medicine Past Accepting new patients
Oscar Medical Center, Inc Past Accepting new patients
Neuse River Emergency Physicians Emergency Medicine Past Accepting new patients
Dodge County Emergency Physicians LLC Emergency Medicine Past Accepting new patients
The Baxley and Appling County Hospital Authority Past Accepting new patients

Locations

3375 Memorial Dr
Ste G
Decatur, GA 30032
Phone (404) 494-6774

3375 Memorial Dr
Decatur, GA 30032
Phone (470) 355-2340

3375 Memorial Dr
Ste B
Decatur, GA 30032
Phone (470) 355-2340

Organizations & group practices 8

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 1

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1699721605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 957598",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300959527",
            "telephone_number": "470-355-2340",
            "fax_number": "470-355-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 MEMORIAL DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300322706",
            "telephone_number": "470-355-2340",
            "fax_number": "470-355-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONYEKABA",
        "first_name": "IGWEBUIKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "039650",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "039650",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "039650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "01045490A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK LICENSE",
            "identifier": "198714",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR",
            "identifier": "01045490B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY LICENSE",
            "identifier": "25MA06176700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.