NPIMap

Individual provider Active NPI

Adaeze Cecilia Ike, M.D

  • Hospitalist Physician
  • Montgomery, AL
National Provider Identifier
1407292840
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD.35425 Issued in AL
Practice address
1725 Pine St
Montgomery, AL 36106-1109
Phone
(334) 293-8736
Fax
(334) 293-8738
NPI assigned
May 13, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD.35425 AL Primary

Addresses

Primary practice location

1725 Pine St
Montgomery, AL 36106-1109

Mailing address

1238 Braybrooke PL
Fayetteville, NC 28314-5993
Phone (919) 260-0052

Other practice location 1

720 Westview Dr SW
Atlanta, GA 30310-1458
Phone (404) 756-1368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20170127002356 AL Practitioner - Internal Medicine 4183927833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 793-8087

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
45.86 of 100Reported as group
Quality
6.09
Improvement activities
40
Cost
81.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.35425ALMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Hospital and Clinic, Inc. Current Accepting new patients
Jackson Hospital & Clinic, Inc. CurrentSince Nov 7, 2016 Accepting new patients
Jackson Hospital and Clinic, Inc. Hospitalist CurrentSince Nov 7, 2016 Accepting new patients
Houston County Healthcare Authority CurrentSince Oct 1, 2025 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Triad of Alabama LLC Past Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1722 Pine St
Ste 503
Montgomery, AL 36106
Phone (334) 240-2337

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1758 Park Pl
Ste 300
Montgomery, AL 36106
Phone (334) 274-1204

Organizations & group practices 6

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 3

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": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407292840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 BRAYBROOKE PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283145993",
            "telephone_number": "919-260-0052",
            "fax_number": "910-339-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 PINE ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061109",
            "telephone_number": "334-293-8736",
            "fax_number": "334-293-8738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Westview Dr SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303101458",
            "country_code": "US",
            "telephone_number": "404-756-1368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IKE",
        "first_name": "ADAEZE",
        "middle_name": "CECILIA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AL",
            "license": "MD.35425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.