Individual provider Active NPI

Ifeoma Nnaji, MD

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1295830701
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
63931 Issued in GA
Practice address
1300 Joseph E Boone Blvd NW
Atlanta, GA 30314-2032
Phone
(678) 843-8790
Fax
(404) 753-6955
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 29280 SC
Family Medicine Physician 207Q00000X 63931 GA Primary
Family Medicine Physician 207Q00000X A113594 CA

Addresses

Primary practice location

1300 Joseph E Boone Blvd NW
Atlanta, GA 30314-2032

Mailing address

1300 Joseph E Boone Blvd NW
Atlanta, GA 30314-2032
Phone (678) 843-8790

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101014000162 GA Practitioner - Family Practice 8325149172 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
63931GAMDFamily Medicine Physician
29280SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morehouse Healthcare, Inc. CurrentSince Jan 1, 2016 Accepting new patients

Locations

1300 Joseph E Boone Blvd NW
Atlanta, GA 30314
Phone (404) 952-1201

75 Piedmont Ave NE
Ste 700
Atlanta, GA 30303
Phone (404) 756-1410

1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086

Interoperability endpoints

  • Direct secure messaging: ms_innaji@landmarkhealth-direct.org

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1295830701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 JOSEPH E BOONE BLVD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303142032",
            "telephone_number": "678-843-8790",
            "fax_number": "404-753-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 JOSEPH E BOONE BLVD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303142032",
            "telephone_number": "678-843-8790",
            "fax_number": "404-753-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NNAJI",
        "first_name": "IFEOMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "29280",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "63931",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A113594",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.