Individual provider Active NPI

Fadi Ahmad Hijazi, M.D.

  • Specialist
  • Columbus, GA
National Provider Identifier
1124109087
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
66501 Issued in GA
Practice address
2032 Wynnton Road Suite a
Columbus, GA 31906-2483
Phone
(706) 322-8820
Fax
(706) 322-8850
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 66501 GA Primary

Addresses

Primary practice location

2032 Wynnton Road Suite a
Columbus, GA 31906-2483

Mailing address

6500 Whittlesey Blvd #220
Columbus, GA 31909-2483
Phone (607) 207-7631

Other identifiers 1

IdentifierTypeStateIssuer
003112813AMedicaidGA

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
002726NYMDMusic Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney & Hypertension, Associates Specialist CurrentSince Jul 20, 2012 Accepting new patients
Advantagehealth Medical Services, PC Past Accepting new patients

Locations

2032 Wynnton Rd
Ste A
Columbus, GA 31906
Phone (706) 322-8820

Organizations & group practices 2

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1124109087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 WHITTLESEY BLVD #220",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092483",
            "telephone_number": "607-207-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2032 WYNNTON ROAD SUITE A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319062483",
            "telephone_number": "706-322-8820",
            "fax_number": "706-322-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIJAZI",
        "first_name": "FADI",
        "middle_name": "AHMAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "66501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003112813A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.