NPIMap

Individual provider Active NPI

Samuel Ikechukwu Ogbuchi Jr., MD

  • Hospitalist Physician
  • Conyers, GA
National Provider Identifier
1912403320
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
88897 Issued in GA
Practice address
1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone
(770) 918-3000
Fax
(404) 367-3558
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 88897 GA
Student in an Organized Health Care Education/Training Program 390200000X GA
Hospitalist Physician 208M00000X 88897 GA Primary

Addresses

Primary practice location

1412 Milstead Ave NE
Conyers, GA 30012-3877

Mailing address

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210621003384 GA Practitioner - Internal MedicinePractitioner - Hospitalist 0042610537 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Morehouse School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Hospitalist Physicians LLCGroup PAC ID 1951299163, 503 clinicians

Practice addresses (Care Compare)

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

Hospital & facility affiliations

  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091
  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
88897GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hardy Renew Wellness,LLC Internal Medicine CurrentSince Jun 1, 2024 Accepting new patients
Georgia Mso LLC CurrentSince Apr 15, 2025 Accepting new patients
Piedmont Hospitalist Physicians LLC Internal Medicine CurrentSince Jul 12, 2021 Accepting new patients
Peachtree Immediate Care FP, LLC CurrentSince Sep 4, 2023 Accepting new patients
Atlanta Ga Opco LLC Past Accepting new patients
Piedmont Rockdale Hospital Inc. Past Accepting new patients

Locations

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

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

590 Lanier Ave W
Fayetteville, GA 30214

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

1640 Powers Ferry Rd SE
Bldg 15
Marietta, GA 30067
Phone (770) 722-9595

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1912403320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 MILSTEAD AVE NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123877",
            "telephone_number": "770-918-3000",
            "fax_number": "404-367-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 MILSTEAD AVE NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123877",
            "telephone_number": "770-918-3000",
            "fax_number": "404-367-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBUCHI",
        "first_name": "SAMUEL",
        "middle_name": "IKECHUKWU",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "88897",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "88897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.