Individual provider Active NPI

Chukwudi Christian Nwawka, MD

  • Obstetrics & Gynecology Physician
  • Riverdale, GA
National Provider Identifier
1891961066
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
040501 Issued in GA
Practice address
33 Upper Riverdale Rd SW Ste 21
Riverdale, GA 30274-2617
Phone
(470) 885-3096
Fax
(770) 991-0041
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 040501 GA Primary

Addresses

Primary practice location

33 Upper Riverdale Rd SW Ste 21
Riverdale, GA 30274-2617

Mailing address

33 Upper Riverdale Rd SW Ste 21
Riverdale, GA 30274-2617
Phone (470) 885-3096

Other identifiers 1

IdentifierTypeStateIssuer
000672185OMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@taragynecology.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20140114000385 IL Practitioner - Obstetrics/Gynecology 2062640386 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040501GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District CurrentSince Jan 1, 2019 Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District CurrentSince Jan 1, 2019 Accepting new patients
Lodestar Obstetrics and Gynecology LTD Obstetrics & Gynecology CurrentSince Feb 1, 2021 Accepting new patients
Prime Healthcare Foundation - Southern Regional, LLC Past Accepting new patients

Locations

203 Medical Way
Ste A
Riverdale, GA 30274
Phone (404) 991-1319

33 Upper Riverdale Rd SW
Ste 21
Riverdale, GA 30274
Phone (770) 897-7043

505 E Grant St
Ste 102
Macomb, IL 61455
Phone (309) 833-5959

503 E Grant St
Macomb, IL 61455
Phone (309) 833-5917

515 E Grant St
Ste 112
Macomb, IL 61455
Phone (309) 833-4104

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1891961066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 UPPER RIVERDALE RD SW STE 21",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742617",
            "telephone_number": "470-885-3096",
            "fax_number": "770-991-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 UPPER RIVERDALE RD SW STE 21",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742617",
            "telephone_number": "470-885-3096",
            "fax_number": "770-991-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAWKA",
        "first_name": "CHUKWUDI",
        "middle_name": "CHRISTIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "040501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000672185O",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@taragynecology.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "33 Upper Riverdale Rd SW Ste 21",
            "city": "Riverdale",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302742617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

Verify at the official NPI Registry.