Individual provider Active NPI

Ibipo Muinat Abdurraheem-Salami, MD

  • Internal Medicine Physician
  • Athens, GA
National Provider Identifier
1962024323
Registry record updated Dec 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
104069 Issued in GA
Practice address
1199 Prince Ave
Athens, GA 30606-2797
Phone
(706) 475-7000
NPI assigned
May 8, 2020
Last updated
Dec 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 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 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 Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230830001824 MO Practitioner - Internal Medicine 9234504812 Reassigns benefits to 3 organizations
I20250701004483 GA Practitioner - Internal Medicine 9234504812 Reassigns benefits to 2 organizations

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
Piedmont Athens Primary Care LLCGroup PAC ID 0648520841, 80 clinicians
Piedmont Athens Hospitalist Physicians LLCGroup PAC ID 6305196411, 174 clinicians

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

LicenseStateTypeSpecialty
2023027653MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC Internal Medicine CurrentSince Aug 7, 2023 Accepting new patients
Piedmont Athens Primary Care LLC CurrentSince Jun 23, 2025 Accepting new patients
Piedmont Athens Hospitalist Physicians LLC Internal Medicine CurrentSince Jan 5, 2026 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 7, 2023 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 7, 2023 Accepting new patients
Mercy Clinic Adult Hospitalists - Washington, LLC CurrentSince Aug 7, 2023 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.

Hospital & facility affiliations 3

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": "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

Verify at the official NPI Registry.