NPIMap

Individual provider Active NPI

Mutinhima Roth Moyo, MD

  • Surgery Physician
  • Cordele, GA
National Provider Identifier
1497763015
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
053004 Issued in GA
Practice address
902 N 7TH St
Cordele, GA 31015-3234
Phone
(229) 276-3100
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 053004 GA Primary
Surgery Physician 208600000X 036139289 IL
Trauma Surgery Physician 2086S0127X 036139289 IL

Addresses

Primary practice location

902 N 7TH St
Cordele, GA 31015-3234

Mailing address

55 Whitcher St NE Ste 130
Marietta, GA 30060-1156
Phone (770) 428-0462

Other practice location 1

95 Collier Rd NW
Suite 6500
Atlanta, GA 30309-1796
Phone (404) 351-5959

Other practice location 2

55 Whitcher St NE Ste 130
Marietta, GA 30060-1156
Phone (770) 428-0462 ext. 08572

Other practice location 3

305 W Jackson St Ste 300
Carbondale, IL 62901-1474
Phone (618) 457-3006

Other identifiers 1

IdentifierTypeStateIssuer
748065683AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmoyo615727@directwellstar.org

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
I20060911000536 GA Practitioner - General Surgery 4486658119 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Emory University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Athens Hospitalist Physicians LLC 174 clinicians
Piedmont Specialty Hospital Billing LLC 252 clinicians
Wellstar Medical Group LLC 3,059 clinicians

Practice addresses (Care Compare)

1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-5076

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-5000

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
  • Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
  • Coliseum Medical Centers, LLC, Dba Hospital, Macon, GA, CCN 110164

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
053004GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Specialty Hospital Billing LLC CurrentSince Jul 22, 2018 Accepting new patients
Acute Care Surgery Medical Group, Inc. Surgery CurrentSince Dec 22, 2022 Accepting new patients
Piedmont Providers LLC CurrentSince Apr 1, 2015 Accepting new patients
Crisp Regional Hospital, Inc CurrentSince Feb 16, 2021 Accepting new patients
Crisp Regional Hospital Inc CurrentSince Feb 16, 2021 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Piedmont Athens Hospitalist Physicians LLC CurrentSince May 7, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Piedmont Athens Specialty Care LLC Surgery Past Accepting new patients
Rock Bridge Surgical Institute, LLC Past Accepting new patients
Northlake Multispecialty Associates LLC Past Accepting new patients

Locations

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

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

95 Collier Rd NW
Ste 6500
Atlanta, GA 30309
Phone (404) 351-5959

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

35 Collier Rd NW
Ste 775
Atlanta, GA 30309
Phone (404) 350-1122

1984 Peachtree Rd NW
Ste 205
Atlanta, GA 30309

970 Joe Frank Harris Pkwy SE
Ste 120
Cartersville, GA 30120
Phone (470) 490-3200

902 N 7th St
Cordele, GA 31015
Phone (229) 276-3100

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

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

55 Whitcher St NE
Ste 130
Marietta, GA 30060
Phone (770) 426-1629

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

1700 Tree Ln
Ste 450
Snellville, GA 30078
Phone (770) 979-9005

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Interoperability endpoints

  • Direct secure messaging: mmoyo615727@directwellstar.org

Organizations & group practices 12

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.

Hospital & facility affiliations 5

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1497763015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 130",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601156",
            "telephone_number": "770-428-0462",
            "fax_number": "770-427-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N 7TH ST",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153234",
            "telephone_number": "229-276-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Collier Rd NW",
            "address_2": "Suite 6500",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303091796",
            "country_code": "US",
            "telephone_number": "404-351-5959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Whitcher St NE Ste 130",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601156",
            "country_code": "US",
            "telephone_number": "770-428-0462 x08572",
            "fax_number": "770-427-8001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 W Jackson St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011474",
            "country_code": "US",
            "telephone_number": "618-457-3006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYO",
        "first_name": "MUTINHIMA",
        "middle_name": "ROTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "053004",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036139289",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036139289",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "748065683A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmoyo615727@directwellstar.org",
            "affiliation": "N",
            "address_1": "55 Whitcher St NE Ste 130",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cordele, GA

Sources for this page

Verify at the official NPI Registry.