Individual provider Active NPI

Brown Nnamdi Ekeledo, MD

  • Surgery Physician
  • Macon, GA
National Provider Identifier
1033157144
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
025151 Issued in GA
Practice address
770 Pine St
Suite 550
Macon, GA 31201-2173
Phone
(478) 746-2719
Fax
(478) 746-4808
NPI assigned
Jun 2, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 025151 GA Primary

Addresses

Primary practice location

770 Pine St
Suite 550
Macon, GA 31201-2173

Mailing address

770 Pine St
Suite 550
Macon, GA 31201-2173
Phone (478) 746-2719

Other identifiers 1

IdentifierTypeStateIssuer
319775OtherGAWELLCARE OF GEORGIA NUMBE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
025151GAMDSurgery Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1033157144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 PINE ST",
            "address_2": "SUITE 550",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012173",
            "telephone_number": "478-746-2719",
            "fax_number": "478-746-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PINE ST",
            "address_2": "SUITE 550",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012173",
            "telephone_number": "478-746-2719",
            "fax_number": "478-746-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKELEDO",
        "first_name": "BROWN",
        "middle_name": "NNAMDI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "025151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF GEORGIA NUMBE",
            "identifier": "319775",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.