MR. OTOBONG ISIDORE UDOUDOH NP
NPI 1902272107
Nurse Practitioner - Pediatrics in Atlanta, GA
About Mr. Otobong Isidore Udoudoh Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. OTOBONG ISIDORE UDOUDOH NP (NPI 1902272107) is an individual pediatrics provider in Atlanta, Georgia, licensed in Georgia (RN186691) and active in the NPI registry since August 2015. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Otobong Isidore Udoudoh Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Otobong Udoudoh reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Columbus, GA 31901
- Reassigned Medicare billing, Georgia enrollment
- 391 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30342 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ATLANTA, GA 30342
ATLANTA, GA 30342
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Otobong Udoudoh's NPI number?
The NPI number for Otobong Udoudoh is 1902272107. It was assigned to this individual provider in the NPPES registry on August 11, 2015.
Where is Otobong Udoudoh located?
Otobong Udoudoh practices at 1001 Johnson Fy Rd NE, Atlanta, GA 30342. The listed phone number is (404) 785-5050.
What is Otobong Udoudoh's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Otobong Udoudoh enrolled in Medicare?
Yes. Otobong Udoudoh is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Otobong Udoudoh's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Otobong Udoudoh reassigns Medicare benefits to Columbus Ambulatory Healthcare Services, Inc. (Columbus, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Otobong Udoudoh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Otobong Udoudoh was last updated on October 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mr. Otobong Isidore Udoudoh, NP · NPI 1902272107
Pediatrics physician in Atlanta, Georgia. Individual provider, active in the CMS NPPES registry since August 11, 2015.
## Identity
- **NPI:** 1902272107 (Entity type: Individual)
- **Enumerated:** August 11, 2015
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** RN186691 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1001 JOHNSON FY RD NE, Atlanta, GA 30342-1605
- **Phone:** (404) 785-5050
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Columbus Ambulatory Healthcare Services, Inc. (NPI 1790733244, Columbus, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 9, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1902272107) · Data from the CMS NPPES public registry.