Active NPI
Antoinette Adjowa Otubea Amevor, MD
- Pediatric Gastroenterology Physician
- Macon, GA
National Provider Identifier
1316387202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 75702
- Practice address
- 1062 Forsyth St Ste 2E
Macon, GA 31201-8631 - Phone
- (478) 633-7330
- Fax
- (478) 633-7360
- NPI assigned
- Jun 25, 2013
- Last updated
- Jul 1, 2022
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 75702 | GA | |
| Pediatrics Physician | 208000000X | 6596 | GA | |
| Pediatric Gastroenterology Physician | 2080P0206X | 35.136478 | OH | |
| Pediatric Gastroenterology Physician | 2080P0206X | 75702 | GA | Primary |
Addresses
Primary practice location
1062 Forsyth St Ste 2E
Macon, GA 31201-8631
Mailing address
1062 Forsyth St Ste 2E
Macon, GA 31201-8631
Phone (478) 633-7330
Other names 1
- Antoinette Walker
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 |
|---|---|---|---|---|
| I20220714002291 | GA | Practitioner - Pediatric Medicine | 6204139892 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients | |
| Major Hospital | Past | Accepting new patients | |
| Choa Multispecialty, LLC | Pediatrics | Past | Accepting new patients |
| Arthur M. Blank Hospital, Inc. | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Children's Hospital
- Atlanta, GA
- NPI 1689744450
-
- Pediatrics Physician
- Brookhaven, GA
- NPI 1437493467
-
dba Memorial Hospital and Manor
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1316387202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1062 FORSYTH ST STE 2E",
"city": "MACON",
"state": "GA",
"postal_code": "312018631",
"telephone_number": "478-633-7330",
"fax_number": "478-633-7360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1062 FORSYTH ST STE 2E",
"city": "MACON",
"state": "GA",
"postal_code": "312018631",
"telephone_number": "478-633-7330",
"fax_number": "478-633-7360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMEVOR",
"first_name": "ANTOINETTE",
"middle_name": "ADJOWA OTUBEA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-25",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "75702",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "6596",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "OH",
"license": "35.136478",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "GA",
"license": "75702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANTOINETTE",
"last_name": "WALKER",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Macon, GA
- American Home Care & Medical Services
- American Medical Systems Inc
- American Oncology Partners, P.a. (Central Georgia Cancer Care)
- American Oncology Partners, P.a. (Central Georgia Cancer Care)
- American Transport Services, LLC
- Amongst Grace Services LLC
- Ashley Danielle Amos, CNM
- Kwame Amponsah
- Serwah Sarponma Amponsah, FNP
- Sam G Amporful, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.