Individual provider Active NPI

Irma Wejuli

  • Podiatrist
  • Macon, GA
National Provider Identifier
1083842637
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD001154 Issued in GA
Practice address
6416 Peake Road
#18
Macon, GA 31210
Phone
(478) 238-5577
Fax
(478) 238-6575
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD001154 GA Primary

Addresses

Primary practice location

6416 Peake Road
#18
Macon, GA 31210

Mailing address

6416 Peake Rd
#18
Macon, GA 31210-3900
Phone (478) 238-5577

Other identifiers 1

IdentifierTypeStateIssuer
POD001154OtherGASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120713000170 GA Practitioner - Podiatry 1658536800 Reassigns benefits to 1 organization
I20151130001862 TN Practitioner - Podiatry 1658536800 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD001154GAMDPodiatrist
744TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Special Care Podiatry of Tennessee, LLC Podiatrist CurrentSince Jul 1, 2015 Accepting new patients
Special Care Podiatry of Georgia, LLC Podiatrist CurrentSince Oct 18, 2014 Accepting new patients
360Care Services of Georgia LLC Past Accepting new patients

Locations

212 GA Highway 49 N
Ste 900
Byron, GA 31008
Phone (305) 542-0830

12910 Shelbyville Rd
Ste 128
Louisville, KY 40243

4350 Brownsboro Rd
Ste 210
Louisville, KY 40207
Phone (830) 212-1661

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

Interoperability endpoints

  • Direct secure messaging: iwejuli@direct.meditouchehr.com
  • Direct secure messaging: irma.wejuli.p2@direct.360care.nextgenshare.com

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": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1083842637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6416 PEAKE RD",
            "address_2": "#18",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312103900",
            "telephone_number": "478-238-5577",
            "fax_number": "478-238-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6416 PEAKE ROAD",
            "address_2": "#18",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31210",
            "telephone_number": "478-238-5577",
            "fax_number": "478-238-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEJULI",
        "first_name": "IRMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "POD001154",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.