Individual provider Active NPI

Maureen Ogbu, NP

  • Family Nurse Practitioner
  • Roswell, GA
National Provider Identifier
1770943185
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NCO-000001 Issued in GA
Practice address
401 Bombay LN
Roswell, GA 30076-5826
Phone
(770) 664-1920
NPI assigned
Feb 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NCO-000001 GA Primary

Addresses

Primary practice location

401 Bombay LN
Roswell, GA 30076-5826

Mailing address

401 Bombay LN
Roswell, GA 30076-5826
Phone (770) 664-1920

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160304001544 GA Practitioner - Nurse Practitioner 8729384581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians

Practice addresses (Care Compare)

1345 Redmond Cir NW
Rome, GA 30165-1307
Phone (910) 742-9243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NCO-000001GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina CurrentSince Dec 1, 2021 Accepting new patients
Lifesource of North Carolina CurrentSince Dec 1, 2021 Accepting new patients
Lifesource of North Carolina Past Accepting new patients

Locations

1345 Redmond Cir NW
Rome, GA 30165
Phone (706) 234-8281

Interoperability endpoints

  • Direct secure messaging: maureen.ogbu.1@27693.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1770943185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BOMBAY LN",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765826",
            "telephone_number": "770-664-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BOMBAY LN",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765826",
            "telephone_number": "770-664-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBU",
        "first_name": "MAUREEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "NCO-000001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.