Individual provider Active NPI

Stephen Otieno Awuor, M.D.

  • Interventional Cardiology Physician
  • Fayetteville, GA
National Provider Identifier
1790047736
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
99684 Issued in GA
Practice address
1267 Highway 54 W Ste 2200
Fayetteville, GA 30214-2110
Phone
(770) 716-0051
NPI assigned
Jun 14, 2012
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 99684 GA
Cardiovascular Disease Physician 207RC0000X 99684 GA
Interventional Cardiology Physician 207RI0011X 036.150090 IL
Cardiovascular Disease Physician 207RC0000X 036.150090 IL
Interventional Cardiology Physician 207RI0011X 99684 GA Primary

Addresses

Primary practice location

1267 Highway 54 W Ste 2200
Fayetteville, GA 30214-2110

Mailing address

1267 Highway 54 W Ste 2200
Fayetteville, GA 30214-2110

Other practice location 1

409 W Oak St
Carbondale, IL 62901
Phone (618) 529-4455

Other practice location 2

3905 W Ernestine Dr
Marion, IL 62959-5800
Phone (618) 529-4455

Other practice location 3

513 N Main St
Anna, IL 62906-1668
Phone (618) 529-4455

Other practice location 4

217 S Park Ave Ste 2
Herrin, IL 62948-3611
Phone (618) 529-4455

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address sawuor28616@sih.direct-ci.com
Direct Messaging Address sawuor28616@sih.direct-ci.com
Direct Messaging Address sawuor28616@sih.direct-ci.com
Direct Messaging Address sawuor28616@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190905002209 IL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 1759528854 Reassigns benefits to 1 organization
I20241028004015 GA Practitioner - Interventional Cardiology 1759528854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

20 Francis Way
Sharpsburg, GA 30277-3589

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 253-1912

795 Poplar Rd
Suite 400
Newnan, GA 30265-2590
Phone (770) 254-6089

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.150090ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Aug 1, 2024 Accepting new patients
Southern Illinois Medical Services, NFP Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Piedmont Athens Specialty Care LLC Cardiovascular Disease Past Accepting new patients

Locations

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

1267 Highway 54 W
Ste 5200
Fayetteville, GA 30214
Phone (770) 460-9777

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

795 Poplar Rd
Ste 400
Newnan, GA 30265
Phone (770) 254-6089

20 Francis Way
Ste 201
Sharpsburg, GA 30277
Phone (770) 254-6089

513 N Main St
Anna, IL 62906
Phone (618) 833-4471

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

409 W Oak St
Carbondale, IL 62901
Phone (618) 536-2565

217 S Park Ave
Ste 2
Herrin, IL 62948

3905 W Ernestine Dr
Marion, IL 62959
Phone (573) 331-5761

Interoperability endpoints

  • Direct secure messaging: sawuor28616@sih.direct-ci.com

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 3

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": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1790047736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W STE 2200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W STE 2200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142110",
            "telephone_number": "770-716-0051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "409 W Oak St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "62901",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3905 W Ernestine Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595800",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "513 N Main St",
            "address_purpose": "LOCATION",
            "city": "Anna",
            "state": "IL",
            "postal_code": "629061668",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 S Park Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483611",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AWUOR",
        "first_name": "STEPHEN",
        "middle_name": "OTIENO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "99684",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "99684",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036.150090",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036.150090",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "99684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sawuor28616@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "409 W Oak St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sawuor28616@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "3905 W Ernestine Dr",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629595800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sawuor28616@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "217 S Park Ave Ste 2",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sawuor28616@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "513 N Main St",
            "city": "Anna",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629061668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.