Internal Medicine of Macon Ga LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

INTERNAL MEDICINE OF MACON GA LLC

Doing business as

Internal Medicine of Macon LLC

Practice address

770 Pine St Ste 210
Macon, GA 31201-7512

Phone

(478) 746-0901

Fax

(478) 250-8395

NPI assigned

Nov 10, 2021

Organization subpart

No

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

Authorized official

Name

Daniel Ukpong, DONPI 1376805192

Title

DO

Phone

(478) 746-0901

Specialties & licenses 2

Addresses

Other names 1

• Internal Medicine of Macon LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Effiong Ukpong, D.O

  • Internal Medicine Physician
  • Chester, PA
  • NPI 1376805192

  GA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1437815826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE 210",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017512",
            "telephone_number": "478-746-0901",
            "fax_number": "478-250-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE 210",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017512",
            "telephone_number": "478-746-0901",
            "fax_number": "478-250-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF MACON GA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-10",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "UKPONG",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "478-746-0901",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Internal Medicine of Macon LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Internal Medicine of Macon LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Associates, P.C.
• James V. Intorcia, A.T.
• Stephanie Garrett Intorcia, APRN
• Maryam Irfan
• Anthony Irlik
• Gera Lynn Irvine, LPC

• Primary Care Clinic/Center in Macon, GA
• Providers in Macon, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.