Active NPI
Eme Idiong Udi
- Gerontology Nurse Practitioner
- Decatur, GA
National Provider Identifier
1508355207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- RN114315
- Practice address
- 1670 Clairmont Rd
Decatur, GA 30033-4004 - Phone
- (404) 321-6111
- NPI assigned
- May 8, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | RN114315 | GA | Primary |
Addresses
Primary practice location
1670 Clairmont Rd
Decatur, GA 30033-4004
Mailing address
1670 Clairmont Rd
Decatur, GA 30033-4004
Phone (404) 321-6111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260515003185 | GA | Practitioner - Nurse Practitioner | 9133698475 |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4703 Roaring Run Rd
Gillett, PA 16925-9691
PO Box
Belfast, ME 04915
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN114315 | GA | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525737600000",
"number": "1508355207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1670 CLAIRMONT RD",
"city": "DECATUR",
"state": "GA",
"postal_code": "300334004",
"telephone_number": "404-321-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1670 CLAIRMONT RD",
"city": "DECATUR",
"state": "GA",
"postal_code": "300334004",
"telephone_number": "404-321-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDI",
"first_name": "EME",
"middle_name": "IDIONG",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-08",
"last_updated": "2018-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "GA",
"license": "RN114315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.