Individual provider Active NPI

Clement C Nwosu, M.D.

  • Nephrology Physician
  • Macon, GA
National Provider Identifier
1659439107
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
033504 Issued in GA
Practice address
1122 Gray Hwy
Ste 4
Macon, GA 31211-1869
Phone
(478) 745-8309
Fax
(478) 745-8364
NPI assigned
Dec 5, 2006
Last updated
Feb 27, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 033504 GA Primary

Addresses

Primary practice location

1122 Gray Hwy
Ste 4
Macon, GA 31211-1869

Mailing address

1122 Gray Hwy
Ste 4
Macon, GA 31211-1869
Phone (478) 745-8309

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120221000535 GA Practitioner - Internal MedicinePractitioner - Nephrology 3971402579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Tulane University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1122 Gray Hwy
Suite 4
Macon, GA 31211-3207
Phone (478) 745-8309

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033504GAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Ga Nephrology Nephrology PastSince Mar 19, 2008 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFDJBD/Endpoint/CFDJBD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1659439107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 GRAY HWY",
            "address_2": "STE 4",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312111869",
            "telephone_number": "478-745-8309",
            "fax_number": "478-745-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 GRAY HWY",
            "address_2": "STE 4",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312111869",
            "telephone_number": "478-745-8309",
            "fax_number": "478-745-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOSU",
        "first_name": "CLEMENT",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "033504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.