26KC Center for Family Medicine

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

50331 Issued in GA

Legal business name

26KC CENTER FOR FAMILY MEDICINE

Practice address

800 Towne Park Dr
Suit 400,
Rincon, GA 31326-5156

Phone

(912) 826-3373

NPI assigned

Oct 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kennedy Kelechi Okere, MD

Title

Medical Director

Phone

(912) 826-3373

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1192838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256428800000",
    "number": "1790974293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 TOWNE PARK DR",
            "address_2": "SUIT 400, P.O .BOX 1599",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265156",
            "telephone_number": "912-308-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TOWNE PARK DR",
            "address_2": "SUIT 400,",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265156",
            "telephone_number": "912-826-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "26KC CENTER FOR FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-20",
        "last_updated": "2009-10-25",
        "status": "A",
        "authorized_official_last_name": "OKERE",
        "authorized_official_first_name": "KENNEDY",
        "authorized_official_middle_name": "KELECHI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "912-826-3373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "50331",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "50331",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000923062E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Rincon, GA
• Providers in Rincon, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2009; 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.