Igwebuike Moses Udeze, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN228894 Issued in GA

Practice address

3721 New Macland Road, Suite 200 - 193
Powder Springs, GA 30127-2000

Phone

(404) 693-5565

Fax

(920) 212-2048

NPI assigned

Dec 16, 2018

Last updated

Nov 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: iudeze67662@directwellstar.org

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.

• Covenant Medical Group LLC

  • Pulmonary Disease Physician
  • Marietta, GA
  • NPI 1194235853
  Medicare reassignment NPD
• Empowering Healthcare Services

  • Clinical Social Worker
  • Douglasville, GA
  • NPI 1316682552

  Primary Care

  Medicare reassignment NPD
• Empowering Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Atlanta, GA
  • NPI 1023864386
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Merit Health

  • Family Nurse Practitioner
  • Powder Springs, GA
  • NPI 1235831512
  Authorized official Same address or phone
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Empowering Management Group of Georgia

  dba Empowering Healthcare Services

  • Durable Medical Equipment & Medical Supplies
  • Atlanta, GA
  • NPI 1962272518
  NPD (past)

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700870400000",
    "number": "1225509573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 NEW MACLAND ROAD, SUITE 200 - 193",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272000",
            "telephone_number": "404-693-5565",
            "fax_number": "920-212-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 NEW MACLAND ROAD, SUITE 200 - 193",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272000",
            "telephone_number": "404-693-5565",
            "fax_number": "920-212-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDEZE",
        "first_name": "IGWEBUIKE",
        "middle_name": "MOSES",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2023-11-25",
        "certification_date": "2022-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN228894",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN228894",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Turcott, D.C.
• Caroline Turner
• Gifty O Twumasi
• Stella Uche
• Blessing Udeh
• Judith E Ugorji
• Eseroghene Ukueku-Boyo, BS PHARMACY
• Kingsley Nwabuko Umezurike, PHARMD
• Upward Autism Center LLC
• Leah Avis Urben, RPH

• Family Nurse Practitioner in Powder Springs, GA
• Providers in Powder Springs, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.