Ijeoma Cecilia Anyanwu, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

81221 Issued in GA

Practice address

684 Sixes Rd Ste 275
Holly Springs, GA 30115-8723

Phone

(770) 852-2440

Fax

(770) 852-2446

NPI assigned

Jun 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ianyanwu672215@nychhc.direct-ci.com

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.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  GA, Pediatrics

  Medicare reassignment NPD
• La Clinica del Nino PC

  • Pediatrics Physician
  • Norcross, GA
  • NPI 1922131374

  Pediatrics

  NPD
• Atlanta Pediatric Partners PC

  • Pediatrics Physician
  • Atlanta, GA
  • NPI 1669599866

  Pediatrics

  NPD (past)
• Dekalb Medical Psych Unit

  • Psychiatric Hospital Unit
  • Decatur, GA
  • NPI 1821099474
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1740418557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 SIXES RD STE 275",
            "city": "HOLLY SPRINGS",
            "state": "GA",
            "postal_code": "301158723",
            "telephone_number": "770-852-2440",
            "fax_number": "770-852-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 SIXES RD STE 275",
            "city": "HOLLY SPRINGS",
            "state": "GA",
            "postal_code": "301158723",
            "telephone_number": "770-852-2440",
            "fax_number": "770-852-2446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2698 Frederick Douglass Blvd",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100301219",
            "country_code": "US",
            "telephone_number": "212-939-8950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3780 Holcomb Bridge Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Peachtree Corners",
            "state": "GA",
            "postal_code": "300924877",
            "country_code": "US",
            "telephone_number": "770-263-9101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANYANWU",
        "first_name": "IJEOMA",
        "middle_name": "CECILIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD446439",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "274604",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "81221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003212061B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003212061C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04078011",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geoffrey Paul Aaron, M.D.
• Oluranti A Aladesanmi, MD
• Sakeena Irene Anderson, NP
• Nasir Ali Asghar, M.D.
• Matthew Kyle Austin, MD
• Holly Megan Barker
• Ashley Michelle Bell, PA-C
• Mary Blalock

• All providers in Holly Springs, GA
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.