Individual provider Active NPI

Edwin Gwira-Tamattey, MD

  • Cardiovascular Disease Physician
  • Gainesville, GA
National Provider Identifier
1346973732
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
103896 Issued in GA
Practice address
200 S Enota Dr NE Ste 100
Gainesville, GA 30501-3466
Phone
(770) 219-9675
NPI assigned
Jul 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125080573 IL
Student in an Organized Health Care Education/Training Program 390200000X 125080573 IL
Cardiovascular Disease Physician 207RC0000X 103896 GA Primary

Addresses

Primary practice location

200 S Enota Dr NE Ste 100
Gainesville, GA 30501-3466

Mailing address

2203 Rea Dr SW
Gainesville, GA 30501-4440
Phone (773) 551-9691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20220813000347 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7517340250

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125080573ILMDInternal Medicine Physician
103896GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Heart Institute LLC Cardiovascular Disease CurrentSince Jul 9, 2025 Accepting new patients

Locations

200 S Enota Dr NE
Ste 100
Gainesville, GA 30501
Phone (770) 219-0950

Organizations & group practices 1

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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1346973732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 REA DR SW",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305014440",
            "telephone_number": "773-551-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ENOTA DR NE STE 100",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013466",
            "telephone_number": "770-219-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWIRA-TAMATTEY",
        "first_name": "EDWIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125080573",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125080573",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "103896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.