GODLY OBOMATE JACK (MD) – Internal Medicine Physician, NPI 1114452588
Internal Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
234 INTERVENTIONAL CARDIOLOGY in GA
Provider Addresses for GODLY OBOMATE JACK (MD)
150 GENTILLY BLVD
CARTERSVILLE, GA 301208522
Phone: (470) 490-6670
Fax: (770) 382-5762
Type: Location
Ambulatory Care Center, 102, Mason Farm Road, Downtown, Chapel Hill, Orange County, North Carolina, 27514, United States
102 MASON FARM RD
CHAPEL HILL, NC 275996134
Phone:
Type: Mailing
221 TECHNOLOGY PKWY NW
ROME, GA 301651369
Phone: (762) 235-1000
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 26 Open Payments records for all available years, with a total value of $2,439.
Total Amount is formed as General ($2,289) + Research ($150) + Ownership ($0) = $2,439.
Last reported payment date: 2024-10-24 • Largest payer in this snapshot: ABIOMED ($964).
Total Amount
$2,439
General + Research + Ownership
Payments
26
Total payment records
General Amount
$2,289
General payments
Research Amount
$150
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABIOMED | $964 |
| Medtronic, Inc. | $408 |
| ShockWave Medical, Inc | $226 |
| Boston Scientific Corporation | $177 |
| Abbott Laboratories | $175 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-06-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240612000296 | I | Interventional Cardiology | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 26 | 26 | $0 |
Insurance plans in this area (ZIP 30120)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| - | GA | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Orthopedic Surgery | GA | |
| Radiation Oncology | GA | |
| - | GA |
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