NPIMap

Individual provider Active NPI

Chiamaka Chisom Ngwudike, MD

  • Family Medicine Physician
  • Powder Springs, GA
National Provider Identifier
1720541881
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
93334 Issued in GA
Practice address
4250 Brownsville Rd
Powder Springs, GA 30127-2559
Phone
(678) 597-8000
Fax
(770) 439-3555
NPI assigned
Apr 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 93334 GA Primary

Addresses

Primary practice location

4250 Brownsville Rd
Powder Springs, GA 30127-2559

Mailing address

4250 Brownsville Rd
Powder Springs, GA 30127-2559
Phone (678) 597-8000

Other practice location 1

1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173
Phone (770) 389-3855

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cngwudike541325@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
I20220920002358 GA Practitioner - Family Practice 5193058659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1680 Hospital S Dr
Austell, GA 30106-8110
Phone (770) 422-1372

4250 Brownsville Rd
Powder Springs, GA 30127-2559
Phone (678) 567-8000

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Feb 1, 2024 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

1680 Hospital South Dr
Austell, GA 30106
Phone (678) 945-2100

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

4250 Brownsville Rd
Powder Springs, GA 30127
Phone (678) 567-8000

Organizations & group practices 5

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 6

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": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1720541881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 BROWNSVILLE RD",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272559",
            "telephone_number": "678-597-8000",
            "fax_number": "770-439-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 BROWNSVILLE RD",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272559",
            "telephone_number": "678-597-8000",
            "fax_number": "770-439-3555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1240 Eagles Landing Pkwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302815173",
            "country_code": "US",
            "telephone_number": "770-389-3855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGWUDIKE",
        "first_name": "CHIAMAKA",
        "middle_name": "CHISOM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-07",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "93334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cngwudike541325@directwellstar.org",
            "affiliation": "N",
            "address_1": "4250 Brownsville Rd",
            "city": "Powder Springs",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301272559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Powder Springs, GA

Sources for this page

Verify at the official NPI Registry.