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Ebima C Okundaye

  • Male

Medical Specialty

Professional ID

  • NPI: 1063546406
  • PECOS ID: 9436221074
  • Enrollment ID: I20141016002094
  • Credential(MD, DO, DPM):
  • Medical School:
  • Medical School Graduation Year: 2002

Hospital Service

  • Hospital CCN1: 430077
  • Business Name (LBN)1: Rapid City Regional Hospital
  • Hospital CCN2: 010131
  • Business Name (LBN)2: Crestwood Medical Center
  • Hospital CCN3: 281341
  • Business Name (LBN)3: Chadron Community Hospital And Health Services
  • Hospital CCN4: 430005
  • Business Name (LBN)4: Prairie Lakes Hospital
  • Hospital CCN5: 531303
  • Business Name (LBN)5: Weston County Health Services

Medical Practices

  • Organization Name: Cantrell Lake Inpatient Services Llc
  • Group Practice ID assigned by PECOS: 1254604101
  • Number of Group Practice member: 6

Location

  • Address1: 200 Allen Memorial Dr
  • Address2:
  • City: Bremen
  • State: Georgia
  • Zip Code: 30110
  • Phone Number: (770)812-2000

Medical Practices

  • Organization Name: Rapid City Regional Hospital Inc
  • Group Practice ID assigned by PECOS: 6002729506
  • Number of Group Practice member: 324

Location

  • Address1: 640 Flormann St
  • Address2:
  • City: Rapid City
  • State: South Dakota
  • Zip Code: 57701
  • Phone Number: (605)719-6980

Medical Practices

  • Organization Name: Physynergy Medical Services Llc
  • Group Practice ID assigned by PECOS: 7810118437
  • Number of Group Practice member: 17

Location

  • Address1: 20 Hughes Rd
  • Address2: Suite 101
  • City: Madison
  • State: Alabama
  • Zip Code: 35758
  • Phone Number: (256)469-7895

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS):
  • Used Electronic health record (EHR):