Individual provider Active NPI

Patrick Ike Ojukwu, M.D.

  • Obstetrics & Gynecology Physician
  • Stockbridge, GA
National Provider Identifier
1790734077
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
050047 Issued in GA
Practice address
1018 Hospital Dr
Stockbridge, GA 30281-7384
Phone
(770) 507-4842
Fax
(770) 507-6964
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 050047 GA Primary

Addresses

Primary practice location

1018 Hospital Dr
Stockbridge, GA 30281-7384

Mailing address

1018 Hospital Dr
Stockbridge, GA 30281-7384
Phone (770) 507-4842

Other identifiers 1

IdentifierTypeStateIssuer
121101876AMedicaidGA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
050047GAMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226448000000",
    "number": "1790734077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 HOSPITAL DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817384",
            "telephone_number": "770-507-4842",
            "fax_number": "770-507-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 HOSPITAL DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817384",
            "telephone_number": "770-507-4842",
            "fax_number": "770-507-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJUKWU",
        "first_name": "PATRICK",
        "middle_name": "IKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2008-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "050047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121101876A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; 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.