Alexander Chukwuma Ibezi-Enendu, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

75636 Issued in GA

Practice address

2809 Pine St
Unadilla, GA 31091-7701

Phone

(478) 355-3000

Fax

(478) 355-3001

NPI assigned

Jun 9, 2011

Last updated

Nov 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Family PracticeAlso: Emergency Medicine

Education

Philadelphia College of Osteopathic Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Taylor Regional Hospital Hospital, Hawkinsville, GA, CCN 110256
• Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069
• Bleckley Memorial Hospital Hospital, Cochran, GA, CCN 111302
• Crisp Regional Hospital Hospital, Cordele, GA, CCN 110104
• Taylor Regional Hospital Hospital, Hawkinsville, GA, CCN 110781
• Fort Valley Crossing of Journey LLC Nursing home, Fort Valley, GA, CCN 115651

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alexander.ibezi-enendu.1@15130.direct.athenahealth.com
• Direct secure messaging: alexanderibezi-enendu@trh.allscriptsdirect.net
• FHIR API: https://fhir4.healow.com/fhir/r4/CHGJBD/Endpoint/CHGJBD

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.

• Malozera Primary Care, LLC

  • Family Medicine Physician
  • Unadilla, GA
  • NPI 1912544784
  Medicare reassignment NPD Authorized official
• Community Primary Care of Georgia LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Gray, GA
  • NPI 1336492511
  Medicare reassignment
• Taylor Regional Hospital

  • Rural Acute Care Hospital
  • Hawkinsville, GA
  • NPI 1720189517
  Medicare reassignment
• Optimus Diagnostics LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Macon, GA
  • NPI 1144609876
  NPD
• Fort Valley Operator LLC

  dba Fort Valley Health and Rehab

  • Skilled Nursing Facility
  • Fort Valley, GA
  • NPI 1093987232
  NPD (past)
• Piedmont Sports Medicine & Orthopaedic Clinic, PC

  dba Barnes Orthopedic Center,LLC

  • Orthopaedic Surgery Physician
  • Macon, GA
  • NPI 1396760260
  NPD (past)

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

• Bleckley County Hospital

  dba Bleckley Memorial Hospital

  • Critical Access Hospital
  • Cochran, GA
  • NPI 1578637526
  Care Compare affiliation
• Crisp Regional Hospital Inc

  dba Crisp Regional Hospital

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649
  Care Compare affiliation
• Fort Valley Operator LLC

  dba Fort Valley Health and Rehab

  • Skilled Nursing Facility
  • Fort Valley, GA
  • NPI 1093987232

  Nursing home

  Care Compare affiliation
• Houston Hospitals Inc

  dba Emory Hospital Perry

  • General Acute Care Hospital
  • Perry, GA
  • NPI 1891808499
  Care Compare affiliation
• Houston Hospitals Inc

  dba Emory Hospital Warner Robins

  • General Acute Care Hospital
  • Warner Robins, GA
  • NPI 1962435792
  Care Compare affiliation
• Taylor Regional Hospital

  • Rural Acute Care Hospital
  • Hawkinsville, GA
  • NPI 1720189517
  Care Compare affiliation

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700265600000",
    "number": "1154615979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 8203",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310958203",
            "telephone_number": "478-355-3000",
            "fax_number": "478-355-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 PINE ST",
            "city": "UNADILLA",
            "state": "GA",
            "postal_code": "310917701",
            "telephone_number": "478-355-3000",
            "fax_number": "478-355-3001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Perry Hwy",
            "address_purpose": "LOCATION",
            "city": "Hawkinsville",
            "state": "GA",
            "postal_code": "310366748",
            "country_code": "US",
            "telephone_number": "478-783-4887",
            "fax_number": "478-783-1877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Elberta Rd",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310931735",
            "country_code": "US",
            "telephone_number": "478-923-3146",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "292 Industrial Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Hawkinsville",
            "state": "GA",
            "postal_code": "310368034",
            "country_code": "US",
            "telephone_number": "478-783-3610",
            "fax_number": "478-783-3611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 S Kimberly Rd",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310888721",
            "country_code": "US",
            "telephone_number": "478-293-4900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "604 Bluebird Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Valley",
            "state": "GA",
            "postal_code": "310305081",
            "country_code": "US",
            "telephone_number": "478-825-2031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBEZI-ENENDU",
        "first_name": "ALEXANDER",
        "middle_name": "CHUKWUMA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-09",
        "last_updated": "2023-11-18",
        "certification_date": "2023-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101019441",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "75636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marian A Conway, NP
• Easy Living Care Home Inc
• Tabatha Turner Hardwick
• Healthcare of Unadilla LLC
• Alicia Henderson
• Kimberly Crump Johnson, NP-C
• Kristie Lashawn Lawson, FNP
• Leisure Life Care Home Inc
• Malozera Primary Care, LLC
• Laquish Denise Martin

• Family Medicine Physician in Unadilla, GA
• Providers in Unadilla, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2023; 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.