Individual provider Active NPI

Olufemi A Ogunyemi, M.D.

  • Interventional Pain Medicine Physician
  • Milledgeville, GA
National Provider Identifier
1942300769
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
045566 Issued in GA
Practice address
111 Fieldstone Dr
Suite 104
Milledgeville, GA 31061-7106
Phone
(478) 414-9900
Fax
(706) 286-7089
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 045566 GA
Interventional Pain Medicine Physician 208VP0014X 045566 GA Primary

Addresses

Primary practice location

111 Fieldstone Dr
Suite 104
Milledgeville, GA 31061-7106

Mailing address

PO Box 80883
Athens, GA 30608-0883
Phone (706) 549-8114

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160607000843 GA Practitioner - Interventional Pain Management 3779496609 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40277TXMDClinical Social Worker
045566GAMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Georgia Spine and Joint Center, LLC CurrentSince Mar 26, 2019 Accepting new patients
South Georgia Spine and Joint Center, LLC CurrentSince Mar 26, 2019 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Interventional Pain Medicine Past Accepting new patients
Au Medical Associates Anesthesia Billing Services, LLC Pain Medicine Past Accepting new patients
Nexus Pain Center of Milledgeville, LLC Interventional Pain Medicine Past Accepting new patients
Colquitt Regional Anesthesia, LLC Past Accepting new patients

Locations

202 S Madison St
Thomasville, GA 31792
Phone (229) 226-1035

Interoperability endpoints

  • Direct secure messaging: olufemiogunyemi@apr.allscriptsdirect.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1942300769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80883",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306080883",
            "telephone_number": "706-549-8114",
            "fax_number": "706-549-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FIELDSTONE DR",
            "address_2": "SUITE 104",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310617106",
            "telephone_number": "478-414-9900",
            "fax_number": "706-286-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNYEMI",
        "first_name": "OLUFEMI",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "045566",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "045566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milledgeville, GA

Sources for this page

Verify at the official NPI Registry.