Active NPI
Ijeoma Viola Ikedum, MD
- Hospitalist Physician
- Marietta, GA
National Provider Identifier
1154024008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 111838
- Practice address
- 677 Church St NE
Marietta, GA 30060-1101 - Phone
- (857) 260-9824
- NPI assigned
- Mar 22, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 111838 | GA | Primary |
Addresses
Primary practice location
677 Church St NE
Marietta, GA 30060-1101
Mailing address
677 Church St NE Lowr Level
Marietta, GA 30060-1101
Phone (470) 956-2020
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230703002226 | GA | Order and Referring Only - Internal Medicine | 4486013802 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782432000000",
"number": "1154024008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "677 CHURCH ST NE LOWR LEVEL",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601101",
"telephone_number": "470-956-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "677 CHURCH ST NE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601101",
"telephone_number": "857-260-9824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IKEDUM",
"first_name": "IJEOMA",
"middle_name": "VIOLA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-22",
"last_updated": "2026-06-26",
"certification_date": "2026-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "GA",
"license": "111838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.