Mercy Internal Medicine Associated PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

054004

Legal business name

MERCY INTERNAL MEDICINE ASSOCIATED PC

Practice address

8225 Mall Pkwy Ste 240
Lithonia, GA 30038-6995

Phone

(770) 484-3092

Fax

(770) 484-3096

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Olufunso A Ojo, M.DNPI 1316991748

Title

Physician

Phone

(770) 484-3095

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olufunso A Ojo, M.D

  • Internal Medicine Physician
  • Lithonia, GA
  • NPI 1316991748
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1710038856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8225 MALL PKWY STE 240",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386995",
            "telephone_number": "770-484-3092",
            "fax_number": "770-484-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8225 MALL PKWY STE 240",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386995",
            "telephone_number": "770-484-3092",
            "fax_number": "770-484-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY INTERNAL MEDICINE ASSOCIATED PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "OJO",
        "authorized_official_first_name": "OLUFUNSO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-484-3095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": "054004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR DR OJO",
            "identifier": "1316991748",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.