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Individual provider Active NPI

Sylvanus Kwame Fiakpornoo, MD

  • Internal Medicine Physician
  • Dallas, GA
National Provider Identifier
1407056302
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50078 Issued in WI
Practice address
2713 Charles Hardy Pkwy
Ste. 223
Dallas, GA 30157-9470
Phone
(678) 324-7021
NPI assigned
Jul 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 50078 WI Primary

Addresses

Primary practice location

2713 Charles Hardy Pkwy
Ste. 223
Dallas, GA 30157-9470

Mailing address

2713 Charles Hardy Pkwy
Ste. 223
Dallas, GA 30157-9470
Phone (678) 324-7021

Other identifiers 4

IdentifierTypeStateIssuer
060453OtherGASTATE LICENSE
29365OtherALSTATE
50078OtherWIWI STATE LICENSE
32521OtherSCSTATE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090727000455 GA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 9032205026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cobbwest Internal Medicine AssociatesGroup PAC ID 1951544139, 3 clinicians

Practice addresses (Care Compare)

848 Hiram Acworth Hwy
Suite a
Hiram, GA 30141-2399
Phone (678) 324-7021

Hospital & facility affiliations

  • Interim Healthcare of Atlanta Inc Home health agency, Atlanta, GA, CCN 117067
  • Central Home Health Care, an Amedisys Company Home health agency, Douglasville, GA, CCN 117050
  • Accentcare Home Health of Georgia Home health agency, Roswell, GA, CCN 117131
  • Bristol Hospice Georgia, LLC Hospice, Atlanta, GA, CCN 111711
  • Pruitthealth Hospice-Union City Hospice, Union City, GA, CCN 111677
  • Agape Hospice Care of Carrollton, LLC Hospice, Villa Rica, GA, CCN 111733
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Powder Springs Center for Nursing & Healing Nursing home, Powder Springs, GA, CCN 115538
  • Roswell Center for Nursing and Healing LLC Nursing home, Roswell, GA, CCN 115422
  • The William Breman Jewish Home Nursing home, Atlanta, GA, CCN 115022
  • Delmar Gardens of Smyrna Nursing home, Smyrna, GA, CCN 115330
  • Christian City Rehabilitation Center Nursing home, Union City, GA, CCN 115573

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50078WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Hospice of Georgia, LLC CurrentSince Aug 12, 2016 Accepting new patients
Cobbwest Internal Medicine Associates Internal Medicine CurrentSince Jul 1, 2013 Accepting new patients
Pruitthealth - Christian City, LLC Past Accepting new patients
PS Operator LLC Past Accepting new patients
C.R. of Autumn Breeze, LLC Past Accepting new patients
Roswell Center for Nursing and Healing LLC Past Accepting new patients
Ecc Hospitalist Services PC Internal Medicine Past Accepting new patients
Delmar Gardens of Smyrna, LLC Past Accepting new patients
Thrive Counseling LLC PastSince Nov 29, 2021 Accepting new patients
Redmond Hospital Services LLC Past Accepting new patients
The William Breman Jewish Home, Inc. Past Accepting new patients
Peachtree Hospice of Georgia, LLC Past Accepting new patients
Roswell Cypress LLC Past Accepting new patients

Locations

135 Gemini Cir
Ste 202
Birmingham, AL 35209
Phone (205) 949-0400

2713 Charles Hardy Pkwy
Ste 223
Dallas, GA 30157
Phone (678) 324-7021

848 Hiram Acworth Hwy
Ste A
Hiram, GA 30141

848 Hiram Acworth Hwy
Ste 200
Hiram, GA 30141
Phone (678) 324-7021

1395 S Marietta Pkwy SE
Ste 116
Marietta, GA 30067
Phone (678) 932-6302

3460 Powder Springs Rd
Powder Springs, GA 30127
Phone (770) 439-9199

1109 Green St
Roswell, GA 30075
Phone (770) 998-1802

354 Corporate Center Ct
Stockbridge, GA 30281
Phone (678) 583-2269

1233 Eagles Landing Pkwy
Ste Ab
Stockbridge, GA 30281
Phone (404) 480-3842

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FECCCA/Endpoint/FECCCA

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bristol Hospice - Georgia LLCAtlanta, GA, CCN 111711 Hospice Contracted Managing Employee Jan 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1407056302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 CHARLES HARDY PKWY",
            "address_2": "STE. 223",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301579470",
            "telephone_number": "678-324-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 CHARLES HARDY PKWY",
            "address_2": "STE. 223",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301579470",
            "telephone_number": "678-324-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIAKPORNOO",
        "first_name": "SYLVANUS",
        "middle_name": "KWAME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "50078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "060453",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "29365",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LICENSE",
            "identifier": "50078",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "32521",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

Verify at the official NPI Registry.