Individual provider Active NPI

Chioma Erondu, M.D.

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
National Provider Identifier
1407241243
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
83107 Issued in GA
Practice address
1841 Clifton Rd NE # 508
Atlanta, GA 30329-4021
Phone
(404) 712-6331
NPI assigned
Mar 30, 2015
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 83107 GA Primary

Addresses

Primary practice location

1841 Clifton Rd NE # 508
Atlanta, GA 30329-4021

Mailing address

1841 Clifton Rd NE # 508
Atlanta, GA 30329-4021
Phone (404) 712-6331

Other practice location 1

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (470) 644-6000

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)
Direct Messaging Address cerondu531907@directwellstar.org Health Information Exchange (HIE)

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
I20200103000774 GA Practitioner - Obstetrics/Gynecology 3971832361 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Obhg Georgia, P.C. Obstetrics & Gynecology CurrentSince Sep 16, 2023 Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607

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.

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1407241243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 CLIFTON RD NE # 508",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294021",
            "telephone_number": "404-712-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 CLIFTON RD NE # 508",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294021",
            "telephone_number": "404-712-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8954 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301342272",
            "country_code": "US",
            "telephone_number": "470-644-6000",
            "fax_number": "470-986-7054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERONDU",
        "first_name": "CHIOMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "83107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Mount Zion Pkwy",
            "city": "Jonesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302362500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cerondu531907@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "8954 Hospital Dr",
            "city": "Douglasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301342272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.