Individual provider Active NPI

Odicie Okeda Fielder, MD

  • Hematology & Oncology Physician
  • Jonesboro, GA
National Provider Identifier
1730364282
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
061065 Issued in GA
Practice address
2400 Mt. Zion Parkway
Kaiser Permanente Southwoode Medical Center
Jonesboro, GA 30236
Phone
(626) 817-2496
NPI assigned
Jan 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 002166 GA
Internal Medicine Physician 207R00000X 061065 GA
Hematology & Oncology Physician 207RH0003X 061065 GA Primary

Addresses

Primary practice location

2400 Mt. Zion Parkway
Kaiser Permanente Southwoode Medical Center
Jonesboro, GA 30236

Mailing address

3495 Pedmont Road, NE
Nine Peidmont Center
Atlanta, GA 30305
Phone (404) 504-5678

Other identifiers 1

IdentifierTypeStateIssuer
002166OtherGALICENSE NUMBER

Other names 1

  • Mrs. Odicie Okeda Fielder Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Carequality Health Information Exchange (HIE)

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
I20090817000622 GA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 5799839304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Yale University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

2400 Mount Zion Pkwy
Jonesboro, GA 30236-2500
Phone (770) 603-3685

2470 Mount Zion Pkwy
BLDG 200
Jonesboro, GA 30236-2500
Phone (770) 527-9031

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

5665 Peachtree Dunwoody Rd
Atlanta, GA 30342-1764
Phone (404) 364-7285

Hospital & facility affiliations

  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
061065GAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Internal Medicine CurrentSince Sep 8, 2016 Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3649

Organizations & group practices 1

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": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1730364282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PEDMONT ROAD, NE",
            "address_2": "NINE PEIDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-504-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MT. ZION PARKWAY",
            "address_2": "KAISER PERMANENTE SOUTHWOODE MEDICAL CENTER",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "30236",
            "telephone_number": "626-817-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDER",
        "first_name": "ODICIE",
        "middle_name": "OKEDA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "002166",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "061065",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "061065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "002166",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Carequality",
            "affiliation": "N",
            "endpointDescription": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Mt. Zion Parkway",
            "address_2": "Kaiser Permanente Southwoode Medical Center",
            "city": "Jonesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ODICIE",
            "last_name": "FIELDER",
            "middle_name": "OKEDA",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jonesboro, GA

Sources for this page

Verify at the official NPI Registry.