Individual provider Active NPI

Ijeoma Ibezue, M.D.

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
National Provider Identifier
1033403787
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
75079 Issued in GA
Practice address
550 Peachtree St NE Ste 1470
Atlanta, GA 30308-2242
Phone
(404) 589-2670
Fax
(404) 589-2671
NPI assigned
May 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 75079 GA Primary

Addresses

Primary practice location

550 Peachtree St NE Ste 1470
Atlanta, GA 30308-2242

Mailing address

550 Peachtree St NE Ste 1470
Atlanta, GA 30308-2242
Phone (404) 589-2670

Other names 1

  • Ijeoma Ibezue Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address iibezue@gawhc.gwaydiect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151125000932 GA Practitioner - Obstetrics/Gynecology 8325298540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Ohio State University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Camille Davis-Williams, M.D., P.C.Group PAC ID 3577458645, 4 clinicians

Practice addresses (Care Compare)

550 Peachtree St NE
Suite 1470
Atlanta, GA 30308-2242
Phone (404) 589-2670

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Camille Davis-Williams, M.D., P.C. Obstetrics & Gynecology CurrentSince Jun 27, 2022 Accepting new patients
Wellstar Cardiovascular Medicine, LLC PastSince Jun 26, 2022 Accepting new patients
Crawford Long Hospital Past Accepting new patients

Locations

550 Peachtree St NE
Ste 1470
Atlanta, GA 30308
Phone (404) 589-2670

Interoperability endpoints

  • Direct secure messaging: ijeoma.ibezue@rwhc.gadirect.net

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1306627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1033403787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE STE 1470",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082242",
            "telephone_number": "404-589-2670",
            "fax_number": "404-589-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE STE 1470",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082242",
            "telephone_number": "404-589-2670",
            "fax_number": "404-589-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBEZUE",
        "first_name": "IJEOMA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-29",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "75079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iibezue@gawhc.gwaydiect.com",
            "affiliation": "N",
            "endpointDescription": "EMR email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "550 Peachtree St NE Ste 1470",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303082242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "IJEOMA",
            "last_name": "IBEZUE",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.