Active NPI
Chioma U Okereke, DNP, NP-BC
- Nurse Practitioner
- Marietta, GA
National Provider Identifier
1881786028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN113110NP
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10033463 | Other | GA | AMERIGROUP |
| 1502260 | Other | LOUISIANNA STATE MEDICAID | |
| 931772211B | Medicaid | GA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160310002128 | GA | Order and Referring Only - Nurse Practitioner | 5597785261 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN113110NP | GA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellness Family Clinic | Past | 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.
-
- Primary Care Clinic/Center
- Marietta, GA
- NPI 1649447673
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.