Fidelis Esosa Uwumiro, M.D

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

Southern Regional Medical Center
11 Upper Riverdale Rd.
Riverdal, GA 30274

Phone

(770) 991-8026

NPI assigned

Jun 7, 2024

Last updated

Dec 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1717718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1851133219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SOUTHERN REGIONAL MEDICAL CENTER",
            "address_2": "11 UPPER RIVERDALE RD",
            "city": "RIVERDAL",
            "state": "GA",
            "postal_code": "30274",
            "telephone_number": "770-991-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTHERN REGIONAL MEDICAL CENTER",
            "address_2": "11 UPPER RIVERDALE RD.",
            "city": "RIVERDAL",
            "state": "GA",
            "postal_code": "30274",
            "telephone_number": "770-991-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UWUMIRO",
        "first_name": "FIDELIS",
        "middle_name": "ESOSA",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.