NPIMap

Individual provider Active NPI

Priscilla Ngozi Chukwueke, MD

  • Psychiatry Physician
  • Stockbridge, GA
National Provider Identifier
1710918933
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
82137 Issued in GA
Practice address
250 Corporate Center CT
Stockbridge, GA 30281-6388
Phone
(678) 619-0280
Fax
(678) 782-6622
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 82137 GA Primary

Addresses

Primary practice location

250 Corporate Center CT
Stockbridge, GA 30281-6388

Mailing address

250 Corporate Center CT
Stockbridge, GA 30281-6388
Phone (678) 619-0280

Other practice location 1

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-2576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190816002603 GA Practitioner - Psychiatry 7416939988 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mind and Energy Psychiatry, LLCGroup PAC ID 2264860113, 3 clinicians

Practice addresses (Care Compare)

37 Calumet Pkwy
Suite 201
Newnan, GA 30263-6734
Phone (770) 683-4538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
82137GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Oak Community Behavioral Health Center CurrentSince Mar 10, 2023 Accepting new patients
Mind & Energy Psychiatry, LLC Psychiatry CurrentSince Feb 1, 2020 Accepting new patients
Georgia Pain and Spine Solutions, PC Past Accepting new patients
Willow Oak Foundation, Inc. PastSince Aug 1, 2020 Accepting new patients
Tri-County Anesthesia, LLC Past Accepting new patients
Georgia Anesthesiologists, PC PastSince Oct 1, 2015 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients
Orange Anesthesia Services P.C.. Past Accepting new patients
Oracle Anesthesia of Georgia LLC PastSince Dec 13, 2011 Accepting new patients
Axis Anesthesia Associates PC Past Accepting new patients
Atlanticare Regional Medical Center Past Accepting new patients

Locations

37 Calumet Pkwy
Ste J102
Newnan, GA 30263

37 Calumet Pkwy
Ste F201
Newnan, GA 30263
Phone (770) 683-4050

6944 Highway 85
Ste F
Riverdale, GA 30274
Phone (770) 683-6946

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18187/brand/1/csg/1/fhir/r4

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1710918933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CORPORATE CENTER CT",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816388",
            "telephone_number": "678-619-0280",
            "fax_number": "678-782-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CORPORATE CENTER CT",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816388",
            "telephone_number": "678-619-0280",
            "fax_number": "678-782-6622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 Lenox Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100371802",
            "country_code": "US",
            "telephone_number": "212-939-2576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUKWUEKE",
        "first_name": "PRISCILLA",
        "middle_name": "NGOZI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "82137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.