Individual provider Active NPI

Enoch Abilash Johnmarie

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1700522463
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
104566 Issued in GA
Practice address
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone
(404) 616-1000
NPI assigned
May 6, 2022
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 104566 GA Primary

Addresses

Primary practice location

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031

Mailing address

2315 NW 98TH Ter
Coral Springs, FL 33065-4949
Phone (954) 937-2773

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250716003706 GA Practitioner - Hospitalist 3274048350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104566GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Internal Medicine CurrentSince Jul 3, 2025 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jul 3, 2025 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Organizations & group practices 3

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 1

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": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1700522463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 NW 98TH TER",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654949",
            "telephone_number": "954-937-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNMARIE",
        "first_name": "ENOCH",
        "middle_name": "ABILASH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-06",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "104566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.