Individual provider Active NPI

Nnedi Udokoro, NP

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1790679777
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN204548 Issued in GA
Practice address
8735 Dunwoody PL Ste R
Atlanta, GA 30350-2995
Phone
(470) 646-6034
Fax
(678) 737-1449
NPI assigned
Jun 5, 2025
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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 RN204548 GA Primary

Addresses

Primary practice location

8735 Dunwoody PL Ste R
Atlanta, GA 30350-2995

Mailing address

2068 Skybrooke CT
Hoschton, GA 30548-6279
Phone (470) 646-6034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN204548GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1790679777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2068 SKYBROOKE CT",
            "city": "HOSCHTON",
            "state": "GA",
            "postal_code": "305486279",
            "telephone_number": "470-646-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8735 DUNWOODY PL STE R",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303502995",
            "telephone_number": "470-646-6034",
            "fax_number": "678-737-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDOKORO",
        "first_name": "NNEDI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN204548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.