Individual provider Active NPI

Okoronkwo Uchenna Ogan, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Monroe, NC
National Provider Identifier
1730230566
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
2009-00327 Issued in NC
Practice address
1969 Wellness Blvd
Monroe, NC 28110-7763
Phone
(704) 316-5775
Fax
(704) 316-5815
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2009-00327 NC
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 2009-00327 NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2009-00327 NC Primary
Internal Medicine Physician 207R00000X 2009-00327 NC
Internal Medicine Physician 207R00000X 34679 GA

Addresses

Primary practice location

1969 Wellness Blvd
Monroe, NC 28110-7763

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-5775

Other practice location 1

2100 Erwin Rd
Durham, NC 27705-3941
Phone (919) 684-8111

Other identifiers 2

IdentifierTypeStateIssuer
P00290748OtherGARAILROAD MEDICARE
000579598CMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address oogan868798@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20100618000196 NC Practitioner - Critical Care (Intensivists)Practitioner - AnesthesiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1052481462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1969 Wellness Blvd
Monroe, NC 28110-7763
Phone (704) 316-5775

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34679GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Critical Care Medicine CurrentSince Feb 15, 2021 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 15, 2021 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Internal Medicine Past Accepting new patients

Locations

1969 Wellness Blvd
Monroe, NC 28110
Phone (704) 316-5775

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: oogan868798@direct.novanthealth.org

Organizations & group practices 4

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 2

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1730230566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-5775",
            "fax_number": "704-316-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 WELLNESS BLVD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281107763",
            "telephone_number": "704-316-5775",
            "fax_number": "704-316-5815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Erwin Rd",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277053941",
            "country_code": "US",
            "telephone_number": "919-684-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGAN",
        "first_name": "OKORONKWO",
        "middle_name": "UCHENNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2009-00327",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NC",
            "license": "2009-00327",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2009-00327",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2009-00327",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "34679",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00290748",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000579598C",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oogan868798@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1969 Wellness Blvd",
            "city": "Monroe",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281107763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.