Infection Specialists of Middle Georgia, LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

55136 Issued in GA

Legal business name

INFECTION SPECIALISTS OF MIDDLE GEORGIA, LLC

Practice address

1420 Watson Blvd
Warner Robins, GA 31093-3446

Phone

(478) 922-5122

Fax

(478) 922-5221

NPI assigned

May 28, 2009

Last updated

Jun 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Modupe Oluwatoyin Ogunsakin

Title

Office Manager

Phone

(478) 922-5122

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mobolaji O Ogunsakin Sr., M.D.

  • Infectious Disease Physician
  • Warner Robins, GA
  • NPI 1871607226

  Internal Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1700011244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933446",
            "telephone_number": "478-922-5122",
            "fax_number": "478-922-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933446",
            "telephone_number": "478-922-5122",
            "fax_number": "478-922-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTION SPECIALISTS OF MIDDLE GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "OGUNSAKIN",
        "authorized_official_first_name": "MODUPE",
        "authorized_official_middle_name": "OLUWATOYIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "478-922-5122",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "55136",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "55136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "721242214A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hypertension and Kidney Associates of Middle Georgia, LLC
• Roberto M. Icarro, M.D.
• Omorogiuwa O Iguobadia, MD
• Imaging Centers of Georgia, Inc.
• Impact Therapy of Georgia (Impact Therapy)
• Infectious Disease Clinic LLC
• Infinite Health Wellness LLC
• Jameshion Lashae Ingram, LPN
• Jarvis Ingram
• Kourtney Ingram, AGACNP-BC

• Infectious Disease Physician in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Infectious Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.