NPIMap

Individual provider Active NPI

Michael R Ikeler, MD

  • Pediatrics Physician
  • Evans, GA
National Provider Identifier
1902808876
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
044942 Issued in GA
Practice address
1205 Town Park LN
Evans, GA 30809-3481
Phone
(706) 868-3100
Fax
(706) 228-3125
NPI assigned
Aug 11, 2005
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 044942 GA
Pediatrics Physician 208000000X 044942 GA Primary

Addresses

Primary practice location

1205 Town Park LN
Evans, GA 30809-3481

Mailing address

1205 Town Park LN
Evans, GA 30809-3481
Phone (706) 868-3100

Other identifiers 1

IdentifierTypeStateIssuer
000832741AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110413000140 GA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 7214949098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Medical University of South Carolina College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Medical GroupGroup PAC ID 7719976521, 14 clinicians

Practice addresses (Care Compare)

1205 Town Park LN
Evans, GA 30809-3481
Phone (706) 868-3100

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christ Community Health Services Augusta, Inc PastSince Jan 1, 2012 Accepting new patients
Juanita G Trimor MD PC Past Accepting new patients
OBGYN Partners of Augusta, Professional Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michael.ikeler.1@7697.direct.athenahealth.com

Organizations & group practices 5

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 8

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1902808876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 TOWN PARK LN",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093481",
            "telephone_number": "706-868-3100",
            "fax_number": "706-868-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 TOWN PARK LN",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093481",
            "telephone_number": "706-868-3100",
            "fax_number": "706-228-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKELER",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "044942",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "044942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000832741A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

Verify at the official NPI Registry.