NPI age
6 years
Enumerated 2019-12-02
● Active Type 2 · Organization
Champ Vascular, Llc
Champ Vascular, Llc is 1 of 238 internal medicine organizations in Georgia.
Primary specialty
Internal Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Odiete
MD Owner
Last NPPES update
2025-05-06
Source: monthly bulk 2026-05
How this organization compares
Across 238 active internal medicine providers in Georgia.
NPI age
6 years
↓ 12 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2019 → 2026
2019-12Enumerated in NPPES
2019
2026
Where they practice
Primary practice location
1825 Highway 34 E Ste 3400
Newnan, GA 302656423
Mailing address
124 Morgan Dr
Lagrange, GA 302406361
Authorized official
Oghenerukevwe Odiete
MD Owner
📞 7704009588
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Sidney Krupa, FNP-C Nurse Practitioner NPI 1255173407
- Everett Mason, DPM Podiatrist NPI 1972535235
- Oghenerukevwe Odiete, MD Internal Medicine NPI 1265758502
Specialties
-
Internal Medicine PrimaryAn area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Peachstate Advanced Cardiac and Endovascular LLC
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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