Fortunate Amarachukwu Ejimone, M.B.B.S.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

91089 Issued in GA

Practice address

720 Westview Dr. SW Morehouse School of Medicine/Gme,
Atlanta, GA 30310

Phone

(404) 752-1500

Fax

(404) 756-1313

NPI assigned

May 29, 2019

Reactivated

May 12, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Medicine Services of Ga LLCGroup PAC ID 2062997505, 90 clinicians

Cogent Healthcare of Georgia PCGroup PAC ID 2961483607, 252 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Health Meadows Hospital Hospital, Vidalia, GA, CCN 110128
• Jeff Davis Hospital Hospital, Hazlehurst, GA, CCN 111333

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cogent Healthcare of Georgia PC

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1609827823
  Medicare reassignment Care Compare group NPD
• Hospital Medicine Services of Ga LLC

  • Hospitalist Physician
  • Savannah, GA
  • NPI 1891653655
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospital Authority of Jeff Davis County Georgia

  dba Jeff Davis Hospital

  • Critical Access Hospital
  • Hazlehurst, GA
  • NPI 1912902263
  Care Compare affiliation
• Vidalia Health Services, LLC

  • General Acute Care Hospital
  • Vidalia, GA
  • NPI 1790376564
  Care Compare affiliation

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1780242420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DR. SW MOREHOUSE SCHOOL OF MEDICINE/GME,",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30310",
            "telephone_number": "404-695-4873",
            "fax_number": "404-756-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DR. SW MOREHOUSE SCHOOL OF MEDICINE/GME,",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30310",
            "telephone_number": "404-752-1500",
            "fax_number": "404-756-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJIMONE",
        "first_name": "FORTUNATE",
        "middle_name": "AMARACHUKWU",
        "name_prefix": "Mr.",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "deactivation_date": "2020-01-16",
        "reactivation_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "91089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kate A Eisenbraun
• Amy Eisenman, MS, NCC, LPC
• Stephanie Eisinger
• Sherief Hatem Eissa
• Robert Ejike
• Andrew Ejiofor, PHARMD
• Chiemezie Ekeomah Ejiogu, MD
• Praise Oghenekevwe Ekakitie, MD
• Ruwanthi Nayanthara Ekanayake
• Cecilia Marta Ekberg, RN

• Internal Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.