NPIMap

Individual provider Active NPI

Anthony Iluyomade, MD

  • Nephrology Physician
  • Toccoa, GA
National Provider Identifier
1437554250
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
80455 Issued in GA
Practice address
58 Big a Rd
Toccoa, GA 30577
Phone
(706) 886-3148
NPI assigned
Oct 23, 2014
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A143245 CA
Nephrology Physician 207RN0300X 80455 GA Primary

Addresses

Primary practice location

58 Big a Rd
Toccoa, GA 30577

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

4150 V St Ste 3500
Sacramento, CA 95817
Phone (916) 734-3774

Other practice location 2

58 Big A Rd
Toccoa, GA 30577
Phone (706) 886-3148

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ailuyomade102890@nghs.gadirect.net Direct

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
I20181205003466 GA Practitioner - NephrologyPractitioner - Internal Medicine 8022352855 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians
Southland Hospitalist Group, LLCGroup PAC ID 8022272913, 22 clinicians

Practice addresses (Care Compare)

450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone (770) 224-1000

915 Gordon Ave
Thomasville, GA 31792-6614
Phone (229) 228-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.79 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A143245CAMDNephrology Physician
80455GAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephens County Hospital Physician Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
North Atlanta Professional Services LLC CurrentSince Apr 1, 2023 Accepting new patients
Icecare LLC Nephrology CurrentSince Jun 1, 2024 Accepting new patients
Southland Hospitalist Group, LLC CurrentSince Feb 15, 2025 Accepting new patients
Stephens County Hospital Physician Group LLC CurrentSince Mar 1, 2020 Accepting new patients
Northeast Georgia Physicians Group Inc CurrentSince Sep 1, 2019 Accepting new patients
John D Archbold Memorial Hospital Inc Past Accepting new patients
Careici LLC Past Accepting new patients
Apogee Medical Group Georgia Inc Past Accepting new patients

Locations

450 Northside Cherokee Blvd
Canton, GA 30115
Phone (770) 224-1000

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

976 Mansell Rd
Roswell, GA 30076
Phone (770) 800-3277

976 Mansell Rd
Ste 500
Roswell, GA 30076
Phone (770) 800-3277

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

115 Rock Quarry Rd
Toccoa, GA 30577
Phone (706) 282-5815

163 Hospital Dr
Toccoa, GA 30577
Phone (706) 282-4200

218 Falls Rd
Toccoa, GA 30577
Phone (706) 282-5840

58 Big a Rd
Toccoa, GA 30577
Phone (706) 886-3148

Organizations & group practices 9

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 4

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": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1437554250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 BIG A RD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "30577",
            "telephone_number": "706-886-3148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 V St Ste 3500",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "95817",
            "country_code": "US",
            "telephone_number": "916-734-3774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "58 Big A Rd",
            "address_purpose": "LOCATION",
            "city": "Toccoa",
            "state": "GA",
            "postal_code": "30577",
            "country_code": "US",
            "telephone_number": "706-886-3148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILUYOMADE",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-23",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A143245",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "80455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ailuyomade102890@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "58 Big A Rd",
            "city": "Toccoa",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toccoa, GA

Sources for this page

Verify at the official NPI Registry.