Agbor Ndiparrey Egbewatt, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

038744 Issued in GA

Practice address

555 Old Norcross Road
Suite 130
Lawrenceville, GA 30045-8703

Phone

(770) 338-5070

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Primary Care Professional Services,LLCGroup PAC ID 9638343924, 313 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  Medicare reassignment Care Compare group NPD
• Internal Medicine Associates of Lawrenceville PC

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1467617043
  Authorized official Same address or phone
• Northside Primary Care Professional Services, LLC

  • Urgent Care Clinic/Center
  • Dawsonville, GA
  • NPI 1215369715
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastside Medical Center, LLC

  dba Piedmont Eastside Medical Center

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Duluth

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063521979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 OLD NORCROSS ROAD",
            "address_2": "SUITE 130",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300458703",
            "telephone_number": "770-338-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 OLD NORCROSS ROAD",
            "address_2": "SUITE 130",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300458703",
            "telephone_number": "770-338-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGBEWATT",
        "first_name": "AGBOR",
        "middle_name": "NDIPARREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "038744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00631463C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Alexis Symone Edwards
• Julie T Edwards, LMSW
• Miriam C Edwards
• Shantreis Edwards, LPC
• Judith Mandip Egbe
• Anthony Egejuru
• Ehi Pharmacy Solutions, LLC.
• Humphrey Nosayaba Ehigiator, PHARMD
• Princewill U Ehirim, MD
• Aleda Ehmer

• Internal Medicine Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.