Individual provider Active NPI

Linus Onyemaechi Ejim, M.D.

  • Nephrology Physician
  • Sandersville, GA
National Provider Identifier
1922091990
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
050617 Issued in GA
Practice address
516 Sparta Rd
Sandersville, GA 31082-1859
Phone
(478) 552-1200
Fax
(478) 552-5600
NPI assigned
Aug 25, 2005
Last updated
Jul 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 050617 GA Primary

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

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040528000694 GA Practitioner - Internal MedicinePractitioner - NephrologyPractitioner - Emergency Medicine 3173504776 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sandersville Hypertension & Nephrology PC Nephrology CurrentSince Oct 4, 2002 Accepting new patients
Agape Community Integrated Health Systems, Inc CurrentSince Mar 17, 2018 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

  • Direct secure messaging: lejim433567@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: linus.ejim@direct.davitaphysiciansolutions.com
  • Direct secure messaging: linus.ejim@oconeeregional.gadirect.net

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 2

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1922091990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 SPARTA ROAD",
            "address_2": "P.O.BOX 761",
            "city": "SANDERSVILLE",
            "state": "GA",
            "postal_code": "31082",
            "telephone_number": "478-552-1200",
            "fax_number": "866-306-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 SPARTA RD",
            "city": "SANDERSVILLE",
            "state": "GA",
            "postal_code": "310821859",
            "telephone_number": "478-552-1200",
            "fax_number": "478-552-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJIM",
        "first_name": "LINUS",
        "middle_name": "ONYEMAECHI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "050617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandersville, GA

Sources for this page

Verify at the official NPI Registry.