Phillip O Ajayi, M.D.
Individual provider Active NPI Pediatrics Physician · Hinesville, GA
NPI 1366769622 · NPPES record last updated May 25, 2021
Key facts
- NPI
- 1366769622
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 49871 (GA)
- Practice address
- 455 S Main St Ste 101
Hinesville, GA 31313-4354 - Phone
- (912) 876-6868
- Fax
- (912) 876-6566
- NPI assigned
- Apr 27, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050113000691 | GA | Practitioner - Pediatric Medicine | 7618926940 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pedsnow LLC | Current |
Accepting new patients | |
| Pedsnow LLC | Current |
Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
863 W Oglethorpe Hwy
Ste 220
Hinesville, GA 31313
Phone (912) 391-1044
Interoperability endpoints
- drajayi@phillipspeds.opdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 49871 | GA | Yes |
Addresses
Primary practice location
455 S Main St Ste 101
Hinesville, GA 31313-4354
Mailing address
455 S Main St
Ste 103
Hinesville, GA 31313-4354
Phone (912) 876-6868
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300039155A | Medicaid | GA |
Other providers in Hinesville, GA
- Sharifa M Abou-Mediene
- About Time LLC.
- Ad&S Personal Care Home, Inc.
- India Marcell Adkins
- Advent Care Systems
- Carron Danielle Alexander
- All Ways Feet of Georgia PC
- All Ways Feet, PC
- Mary Alice Allcott
- Joshua Brooks Allen
All providers in Hinesville, GA · Pediatrics Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.