Individual provider Active NPI

Michael Ofori, M.D

  • Emergency Medicine Physician
  • Riverdale, GA
National Provider Identifier
1811302839
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
78145 Issued in GA
Practice address
11 Upper Riverdale Rd SW
Riverdale, GA 30274-2615
Phone
(770) 994-9326
NPI assigned
Jun 28, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 78145 GA Primary

Addresses

Primary practice location

11 Upper Riverdale Rd SW
Riverdale, GA 30274-2615

Mailing address

390 17TH Street
Unit 2061
Atlanta (and Vicinity), GA 30363-3912
Phone (423) 650-5519

Other practice location 1

3635 Vista Ave
Saint Louis, MO 63110-2539
Phone (314) 577-8780

Other practice location 2

11 upper Riverdale
Atlanta (and vicinity), GA 30274
Phone (770) 991-8000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171004001136 GA Practitioner - Emergency MedicinePractitioner - Internal Medicine 0648572073 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coweta Emergency Group LLCGroup PAC ID 5395876452, 28 clinicians

Practice addresses (Care Compare)

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 253-1912

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
78145GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Regional Physicians Management Group, LLC CurrentSince Nov 1, 2018 Accepting new patients
Small Hospital Innovations LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Coweta Emergency Group LLC Emergency Medicine CurrentSince Jun 1, 2019 Accepting new patients
Walker Lake Emergency Group, PC Emergency Medicine CurrentSince Apr 3, 2019 Accepting new patients
Lagrange Emergency Physicians, LLC Emergency Medicine CurrentSince Sep 1, 2017 Accepting new patients

Locations

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1514 Vernon Rd
Lagrange, GA 30240
Phone (706) 812-2369

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1403913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1811302839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 17TH STREET",
            "address_2": "UNIT 2061",
            "city": "ATLANTA (AND VICINITY)",
            "state": "GA",
            "postal_code": "303633912",
            "telephone_number": "423-650-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 UPPER RIVERDALE RD SW",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742615",
            "telephone_number": "770-994-9326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3635 Vista Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631102539",
            "country_code": "US",
            "telephone_number": "314-577-8780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 upper Riverdale",
            "address_purpose": "LOCATION",
            "city": "Atlanta (and vicinity)",
            "state": "GA",
            "postal_code": "30274",
            "country_code": "US",
            "telephone_number": "770-991-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OFORI",
        "first_name": "MICHAEL",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "78145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

Verify at the official NPI Registry.