NPIMap

Individual provider Active NPI

Okechukwu Jideofor Obi, MD

  • Family Medicine Physician
  • Harrisburg, NC
National Provider Identifier
1922689447
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
303065 Issued in NC
Practice address
4315 Physicians Blvd Ste 101
Harrisburg, NC 28075-7431
Phone
(704) 455-6521
Fax
(704) 455-3078
NPI assigned
Apr 16, 2021
Last updated
Apr 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 303065 NC Primary

Addresses

Primary practice location

4315 Physicians Blvd Ste 101
Harrisburg, NC 28075-7431

Mailing address

270 Copperfield Blvd NE Ste 202
Concord, NC 28025-2441
Phone (704) 721-2060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241202002570 NC Practitioner - HospitalistPractitioner - Family Practice 0941602080 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

301 Yadkin St
Albemarle, NC 28001-3441
Phone (980) 312-4690

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
303065NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Sep 22, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 22, 2024 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 22, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 22, 2024 Accepting new patients

Locations

301 Yadkin St
Albemarle, NC 28001
Phone (704) 984-4000

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

4315 Physicians Blvd
Ste 101
Harrisburg, NC 28075
Phone (704) 455-6521

Interoperability endpoints

  • Direct secure messaging: oobi833993@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1922689447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 COPPERFIELD BLVD NE STE 202",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252441",
            "telephone_number": "704-721-2060",
            "fax_number": "704-403-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 PHYSICIANS BLVD STE 101",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280757431",
            "telephone_number": "704-455-6521",
            "fax_number": "704-455-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBI",
        "first_name": "OKECHUKWU",
        "middle_name": "JIDEOFOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "303065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, NC

Sources for this page

Verify at the official NPI Registry.