Individual provider Active NPI

Irene Murema, MD

  • Pediatrics Physician
  • Valdosta, GA
National Provider Identifier
1063839983
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
78632 Issued in GA
Practice address
105 W Cranford Ave
Valdosta, GA 31602-2930
Phone
(229) 247-7350
Fax
(229) 242-1730
NPI assigned
Mar 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 78632 GA Primary

Addresses

Primary practice location

105 W Cranford Ave
Valdosta, GA 31602-2930

Mailing address

105 W Cranford Ave
Valdosta, GA 31602-2930
Phone (229) 247-7350

Other practice location 1

2040 W Charleston Blvd
Las Vegas, NV 89102-2227
Phone (702) 671-2236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190109000788 TX Practitioner - Pediatric Medicine 9234432824 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78632GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital CurrentSince Nov 10, 2018 Accepting new patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Nov 10, 2018 Accepting new patients
Valley Children's Medical Group Pediatrics Past Accepting new patients
Sierra View Local Health Care District Past Accepting new patients
Valley Children's Hospital Past Accepting new patients
Unsom Multi-Spec GRP Pract S Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: imurema2712601@direct.trinity-health.org
  • Direct secure messaging: imurema16087@valleychildrens-prd.direct-ci.com

Organizations & group practices 7

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": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063839983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W CRANFORD AVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022930",
            "telephone_number": "229-247-7350",
            "fax_number": "229-242-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W CRANFORD AVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022930",
            "telephone_number": "229-247-7350",
            "fax_number": "229-242-1730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 W Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022227",
            "country_code": "US",
            "telephone_number": "702-671-2236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUREMA",
        "first_name": "IRENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "78632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.