Aiwane Iboaya, D.O

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

82949 Issued in GA

Practice address

1900 10TH Ave
Suite # 100
Columbus, GA 31901-3600

Phone

(706) 571-1430

Fax

(706) 571-1604

NPI assigned

Apr 23, 2014

Last updated

Aug 8, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physical Medicine and Rehabilitation

Education

Ohio University, College of Osteopathic Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Atlanta Pmandr IncGroup PAC ID 3971995382, 6 clinicians

Shepherd Center, Inc.Group PAC ID 1052301777, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
• Shepherd Center Long-term care hospital, Atlanta, GA, CCN 112003

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Atlanta PM&R Inc

  • Physical Medicine & Rehabilitation Physician
  • Suwanee, GA
  • NPI 1588321970

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Shepherd Center Inc

  • Long Term Care Hospital
  • Atlanta, GA
  • NPI 1043311715

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

• Eastside Medical Center, LLC

  dba Piedmont Eastside Medical Center

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation
• Ehca Johns Creek, LLC

  dba Emory Johns Creek Hospital

  • General Acute Care Hospital
  • Johns Creek, GA
  • NPI 1679632137
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Forsyth

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Duluth

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation
• Shepherd Center Inc

  • Long Term Care Hospital
  • Atlanta, GA
  • NPI 1043311715

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1386064814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091426",
            "telephone_number": "404-352-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 10TH AVE",
            "address_2": "SUITE # 100",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319013600",
            "telephone_number": "706-571-1430",
            "fax_number": "706-571-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBOAYA",
        "first_name": "AIWANE",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "82949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Ann Hyatt
• Janet Ann Hyder, D.C.
• Morgan Carter Hyneman, DPM
• Zoey Hypes
• I Basilio MD, PC
• Akram Ibrahim, MD
• Ideal Smile Dentistry LLC
• Idealsmile
• Daniel Ikeagu
• Anne Lyle Illges, OTR/L

• Physical Medicine & Rehabilitation Physician in Columbus, GA
• Providers in Columbus, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.