Ifeoma Okponyia, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

97246 Issued in GA

Practice address

101 Quartz Dr Ste 201&203
Villa Rica, GA 30180-3255

Phone

(770) 459-4411

Fax

(770) 456-3785

NPI assigned

Mar 30, 2020

Last updated

Mar 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tanner Home Health Services Home health agency, Carrollton, GA, CCN 117319
• Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Tanner Medical Group Inc

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1396979787

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

• TMC Home Health Inc

  • Home Health Agency
  • Carrollton, GA
  • NPI 1457376386
  Care Compare affiliation
• TMC/Villa Rica Hospital, Inc

  dba Tanner Health System

  • General Acute Care Hospital
  • Villa Rica, GA
  • NPI 1851388748
  Care Compare affiliation

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1831727379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GREENWAY BLVD FL 2",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174338",
            "telephone_number": "770-838-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 QUARTZ DR STE 201&203",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301803255",
            "telephone_number": "770-459-4411",
            "fax_number": "770-456-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKPONYIA",
        "first_name": "IFEOMA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "97246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.