Individual provider Active NPI

Mary Ogechukwu Muoneke

  • Nephrology Physician
  • Atlanta, GA
National Provider Identifier
1497042527
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
074194 Issued in GA
Practice address
1364 Clifton Rd NE
Emory University Hospital - Nephrology
Atlanta, GA 30322-1059
Phone
(404) 712-5676
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.017366 OH
Nephrology Physician 207RN0300X 074194 GA Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Emory University Hospital - Nephrology
Atlanta, GA 30322-1059

Mailing address

1364 Clifton Rd NE
Emory University Hospital - Nephrology
Atlanta, GA 30322-1059
Phone (404) 712-5676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200526000951 PA Practitioner - Internal Medicine 2860621406 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.017366OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenixville Clinic Company LLC CurrentSince Jun 29, 2020 Accepting new patients
Phoenixville Clinic Company LLC CurrentSince Jun 29, 2020 Accepting new patients

Locations

140 Nutt Rd
Phoenixville, PA 19460
Phone (610) 983-1000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1497042527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "address_2": "EMORY UNIVERSITY HOSPITAL - NEPHROLOGY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-712-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "address_2": "EMORY UNIVERSITY HOSPITAL - NEPHROLOGY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-712-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUONEKE",
        "first_name": "MARY",
        "middle_name": "OGECHUKWU",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.017366",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "074194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.