Osaretin Daniel Okungbowa, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

62926 Issued in GA

Practice address

23 Lester Rd
Statesboro, GA 30458-4700

Phone

(912) 225-1836

Fax

(912) 225-0645

NPI assigned

Aug 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

Texas Tech University Health Science Center School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Statesboro, GA, CCN 117033
• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GBEHAA/Endpoint/GBEHAA

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.

• Victoria Family Practice Clinic, LLC

  • Family Medicine Physician
  • Statesboro, GA
  • NPI 1700119997
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation
• Healthfield of Statesboro, LLC

  • Home Health Agency
  • Statesboro, GA
  • NPI 1942230750
  Care Compare affiliation

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1740474154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 LESTER RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584700",
            "telephone_number": "912-225-1836",
            "fax_number": "912-225-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 LESTER RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584700",
            "telephone_number": "912-225-1836",
            "fax_number": "912-225-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUNGBOWA",
        "first_name": "OSARETIN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2009-0144",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "62926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420313629A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ogeechee OB-GYN, P.C.
• Ogeechee Wound Healing, Inc
• Steven Christopher Joel Oglesby
• Patrick Okojie
• Oksl LLC
• Benjamin Turner Oldham, MD
• Olivia Egan Counseling Services, LLC
• Joy Oloyede
• Optim Orthopedics, LLC
• Orthopedic Center PC

• Family Medicine Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.