NPIMap

Individual provider Active NPI

Chinedum Ikpe Clark, M.D.

  • Emergency Medicine Physician
  • Atlanta, GA
National Provider Identifier
1740443902
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D0106335 Issued in MD
Practice address
1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone
(404) 605-5000
NPI assigned
Jul 8, 2008
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 66121 GA
Emergency Medicine Physician 207P00000X D0106335 MD Primary

Addresses

Primary practice location

1968 Peachtree Rd NW
Atlanta, GA 30309-1281

Mailing address

120 Elenor Dr
Fayetteville, GA 30215-2051
Phone (404) 545-7732

Other practice location 1

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 400-1152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110608000602 GA Practitioner - Emergency Medicine 7719164334 Reassigns benefits to 2 organizations
I20260326000138 PA Practitioner - Emergency Medicine 7719164334 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahn Emergency Group of Canonsburg LTDGroup PAC ID 2668695834, 4 clinicians
Piedmont Ed Professionals LLCGroup PAC ID 1759543176, 37 clinicians
Ahn Emergency Group of Erie County LTDGroup PAC ID 3072746585, 6 clinicians
Ahn Emergency Group of Pittsburgh LTDGroup PAC ID 6608009741, 8 clinicians

Practice addresses (Care Compare)

12351 Perry Hwy
Wexford, PA 15090-8344
Phone (878) 231-5100

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-2800

2 W Crescent Park
Warren, PA 16365-2111
Phone (814) 452-5000

6321 Route 30
Greensburg, PA 15601-9703
Phone (878) 295-4735

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66121GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Ed Professionals, LLC Emergency Medicine CurrentSince Nov 14, 2022 Accepting new patients
Coweta Emergency Group LLC Emergency Medicine CurrentSince May 15, 2011 Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

Organizations & group practices 8

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 9

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1740443902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 ELENOR DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152051",
            "telephone_number": "404-545-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091281",
            "telephone_number": "404-605-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "745 Poplar Rd",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302651618",
            "country_code": "US",
            "telephone_number": "770-400-1152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHINEDUM",
        "middle_name": "IKPE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "66121",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0106335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.