Individual provider Active NPI

Ndausung Udongwo, MD

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1356970354
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
96914 Issued in GA
Practice address
705 Juniper St NE
Atlanta, GA 30308-1307
Phone
(770) 742-3883
Fax
(855) 597-8504
NPI assigned
Apr 2, 2020
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 96914 GA Primary

Addresses

Primary practice location

705 Juniper St NE
Atlanta, GA 30308-1307

Mailing address

483 Upper Riverdale Rd SW Ste F
Riverdale, GA 30274-2579
Phone (770) 742-3883

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
I20241121003577 GA Practitioner - Internal Medicine 3577098961 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians
Covenant Medical Group LLCGroup PAC ID 4082969241, 17 clinicians

Practice addresses (Care Compare)

1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 778-3900

483 Upper Riverdale Rd SW
Suite L
Riverdale, GA 30274-2579
Phone (770) 742-3883

483 Upper Riverdale Rd SW
Suite L
Riverdale, GA 30274-2584

535 Coliseum Dr
Macon, GA 31217-0104
Phone (239) 220-6601

705 Juniper St NE
Atlanta, GA 30308-1307
Phone (770) 742-3883

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group LLC CurrentSince Sep 1, 2024 Accepting new patients
Emory Specialty Associates, LLC Internal Medicine CurrentSince Jan 30, 2025 Accepting new patients
Wellstar Medical Group, LLC PastSince Jul 15, 2026 Accepting new patients

Locations

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

705 Juniper St NE
Atlanta, GA 30308
Phone (404) 873-2871

483 Upper Riverdale Rd SW
Ste L
Riverdale, GA 30274
Phone (770) 742-3883

Interoperability endpoints

  • Direct secure messaging: nudongwo924991@direct.emory.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1356970354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 UPPER RIVERDALE RD SW STE F",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742579",
            "telephone_number": "770-742-3883",
            "fax_number": "855-597-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 JUNIPER ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081307",
            "telephone_number": "770-742-3883",
            "fax_number": "855-597-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDONGWO",
        "first_name": "NDAUSUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "96914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.