Individual provider Active NPI

Michael Ogbenna Iteogu, RPH

  • Pharmacist
  • Macon, GA
National Provider Identifier
1932789104
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH013513 Issued in GA
Practice address
1377 Pio Nono Ave
Macon, GA 31204-4633
Phone
(478) 314-0021
Fax
(478) 742-1428
NPI assigned
Apr 12, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH013513 GA Primary

Addresses

Primary practice location

1377 Pio Nono Ave
Macon, GA 31204-4633

Mailing address

1169 Forsyth St
Macon, GA 31201-1735
Phone (478) 957-3370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH013513GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Support Associates PC PastSince Apr 20, 2021 Accepting new patients
M&E Pharmacy Services Inc PastSince Apr 20, 2021 Accepting new patients
Unionville Discount Pharmacy Inc PastSince Apr 20, 2021 Accepting new patients
Unionville Discount Pharmacy Inc Pharmacist PastSince Apr 20, 2021 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1932789104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 FORSYTH ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011735",
            "telephone_number": "478-957-3370",
            "fax_number": "478-746-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1377 PIO NONO AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312044633",
            "telephone_number": "478-314-0021",
            "fax_number": "478-742-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITEOGU",
        "first_name": "MICHAEL",
        "middle_name": "OGBENNA",
        "name_prefix": "Dr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH013513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.