Linus Onyemaechi Ejim, M.D.
Individual provider Active NPI Nephrology Physician · Sandersville, GA
NPI 1922091990 · NPPES record last updated Jul 22, 2022
Key facts
- NPI
- 1922091990
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 050617 (GA)
- Practice address
- 516 Sparta Rd
Sandersville, GA 31082-1859 - Phone
- (478) 552-1200
- Fax
- (478) 552-5600
- NPI assigned
- Aug 25, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1987
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
516 Sparta Rd
Sandersville, GA 31082-1859
Phone (478) 552-1200
Hospital & facility affiliations
- Washington County Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040528000694 | GA | Practitioner - Internal Medicine |
3173504776 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandersville Hypertension & Nephrology PC | Nephrology | Current |
Accepting new patients |
| Agape Community Integrated Health Systems, Inc | Current |
Accepting new patients | |
| Smith Medical Nursing Care Center, Inc | Past | Accepting new patients |
Locations
5536 Old National Hwy
Ste 100
College Park, GA 30349
Phone (404) 564-4796
516 Sparta Rd
Sandersville, GA 31082
Phone (478) 552-1200
Interoperability endpoints
- linus.ejim@oconeeregional.gadirect.net
- linus.ejim@direct.davitaphysiciansolutions.com
- lejim433567@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 050617 | GA | Yes |
Addresses
Primary practice location
516 Sparta Rd
Sandersville, GA 31082-1859
Mailing address
516 Sparta Road
P.O.Box 761
Sandersville, GA 31082
Phone (478) 552-1200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00978425A | Medicaid | GA |
Other providers in Sandersville, GA
- Dav-Way Investments, Inc
- Terri Dawson
- John W Dickey
- Phillip Douglas
- E Chandler McDavid
- Emerald Emt, LLC.
- Victor I Etheridge
- Michelle Prince Evans
- Constance Danielle Francis
- Ronald P. Freeman
All providers in Sandersville, GA · Nephrology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.