Active NPI
Ibipo Muinat Abdurraheem-Salami, MD
- Internal Medicine Physician
- Athens, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 104069
- Practice address
- 1199 Prince Ave
Athens, GA 30606-2797 - Phone
- (706) 475-7000
- NPI assigned
- May 8, 2020
- Last updated
- Dec 24, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2023027653 | MO | |
| Internal Medicine Physician | 207R00000X | 104069 | GA | Primary |
Addresses
Primary practice location
1199 Prince Ave
Athens, GA 30606-2797
Mailing address
1199 Prince Ave
Athens, GA 30606-2797
Other practice location 1
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6339
Other practice location 2
901 E 5th St
Washington, MO 63090-3127
Phone (636) 239-8231
Other practice location 3
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1328
Other practice location 4
1400 US Highway 61
Festus, MO 63028-4100
Phone (636) 933-5337
Other names 1
- Ms. Ibipo Muinat Otaiku
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-7000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023027653 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Adult Hospitalists- Jefferson, LLC | Internal Medicine | Current | Accepting new patients |
| Piedmont Athens Primary Care LLC | Current | Accepting new patients | |
| Piedmont Athens Hospitalist Physicians LLC | Internal Medicine | Current | Accepting new patients |
| Mercy Hospitals East Communities | Current | Accepting new patients | |
| Mercy Hospitals East Communities | Current | Accepting new patients | |
| Mercy Clinic Adult Hospitalists - Washington, LLC | Current | Accepting new patients | |
| Piedmont Athens Specialty Care LLC | Past | Accepting new patients | |
| Piedmont Athens Regional Medical Center, Inc. | Past | Accepting new patients | |
| Mercy Hospital South | Past | Accepting new patients |
Locations
1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520
1199 Prince Ave
#70
Athens, GA 30606
Phone (706) 475-7055
1270 Prince Ave
Ste 102
Athens, GA 30606
Phone (706) 475-7055
1270 Prince Ave
Ste 201
Athens, GA 30606
Phone (470) 271-3427
2142 W Broad St
Bldg 200
Athens, GA 30606
Phone (706) 548-6881
1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111
10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328
615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687
615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075
901 E 5th St
Washington, MO 63090
Phone (636) 239-8000
Organizations & group practices 9
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1578079000
-
- Family Medicine Physician
- Athens, GA
- NPI 1245746783
-
- Hospitalist Physician
- Washington, MO
- NPI 1891943429
-
- Internal Medicine Physician
- Festus, MO
- NPI 1083052492
-
dba Mercy St. Louis Transport Ambulance
- Land Ambulance
- Saint Louis, MO
- NPI 1881329902
-
- General Acute Care Hospital
- Athens, GA
- NPI 1437186111
-
- Cardiovascular Disease Physician
- Athens, GA
- NPI 1184130627
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1568481984
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Atrium Health Navicent Baldwin
- General Acute Care Hospital
- Milledgeville, GA
- NPI 1841701562
-
- General Acute Care Hospital
- Athens, GA
- NPI 1437186111
-
- General Acute Care Hospital
- Monroe, GA
- NPI 1720589328
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766534400000",
"number": "1962024323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1199 PRINCE AVE",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1199 PRINCE AVE",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062797",
"telephone_number": "706-475-7000"
}
],
"practiceLocations": [
{
"address_1": "615 S New Ballas Rd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631418221",
"country_code": "US",
"telephone_number": "314-251-6339",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "901 E 5th St",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "MO",
"postal_code": "630903127",
"country_code": "US",
"telephone_number": "636-239-8231",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10010 Kennerly Rd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631282106",
"country_code": "US",
"telephone_number": "314-525-1328",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1400 US Highway 61",
"address_purpose": "LOCATION",
"city": "Festus",
"state": "MO",
"postal_code": "630284100",
"country_code": "US",
"telephone_number": "636-933-5337",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABDURRAHEEM-SALAMI",
"first_name": "IBIPO",
"middle_name": "MUINAT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-08",
"last_updated": "2025-12-24",
"certification_date": "2025-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2023027653",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "104069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "IBIPO",
"last_name": "OTAIKU",
"middle_name": "MUINAT",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.