Individual provider Active NPI

Chioma U Okereke, DNP, NP-BC

  • Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1881786028
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN113110NP Issued in GA
Practice address
2317 Austell Rd SW
Marietta, GA 30008-4537
Phone
(678) 213-3137
Fax
(678) 213-3139
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN113110NP GA Primary

Addresses

Primary practice location

2317 Austell Rd SW
Marietta, GA 30008-4537

Mailing address

2317 Austell Rd SW
Marietta, GA 30008-4537
Phone (678) 213-3137

Other identifiers 3

IdentifierTypeStateIssuer
10033463OtherGAAMERIGROUP
1502260OtherLOUISIANNA STATE MEDICAID
931772211BMedicaidGA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160310002128 GA Order and Referring Only - Nurse Practitioner 5597785261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN113110NPGAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Family Clinic PastSince Oct 5, 2005 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1881786028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 AUSTELL RD SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300084537",
            "telephone_number": "678-213-3137",
            "fax_number": "678-213-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 AUSTELL RD SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300084537",
            "telephone_number": "678-213-3137",
            "fax_number": "678-213-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEREKE",
        "first_name": "CHIOMA",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "credential": "DNP, NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN113110NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10033463",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANNA STATE MEDICAID",
            "identifier": "1502260",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "931772211B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.