Central Georgia Pediatrics, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

039194 Issued in GA

Legal business name

CENTRAL GEORGIA PEDIATRICS, INC.

Practice address

844 2ND St
Macon, GA 31201-6885

Phone

(478) 746-6662

Fax

(478) 746-8861

NPI assigned

Apr 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Obioha Louis Okoro, M.D.NPI 1114070802

Title

President

Phone

(478) 746-6662

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Central Georgia Pediatrics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Central Georgia Pediatrics, Inc.

  • Pediatric Adolescent Medicine Physician
  • Macon, GA
  • NPI 1386912319
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Obioha Louis Okoro, MD

  • Pediatrics Physician
  • Macon, GA
  • NPI 1114070802

  Specialist

  NPD (past) Authorized official

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992922744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 2ND ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016885",
            "telephone_number": "478-746-6662",
            "fax_number": "478-746-8861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 2ND ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016885",
            "telephone_number": "478-746-6662",
            "fax_number": "478-746-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL GEORGIA PEDIATRICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OKORO",
        "authorized_official_first_name": "OBIOHA",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-746-6662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "039194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "826405",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319585",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Georgia Internist
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• Central Georgia MRI LLC
• Central Georgia Oral and Maxillofacial Surgery, LLC
• Central Georgia Pediatrics, Inc.
• Central Georgia Pet LLC
• Central Georgia Pulmonary Associates, LLC
• Central Georgia Radiation Oncology Center
• Central Georgia Rehabilitation
• Central Georgia Senior Health, Inc.

• All providers in Macon, GA
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.