Ibipo Muinat Abdurraheem-Salami, MD
Individual provider Active NPI Internal Medicine Physician · Athens, GA
NPI 1962024323 · NPPES record last updated Dec 24, 2025
Key facts
- NPI
- 1962024323
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 104069 (GA)
- Practice address
- 1199 Prince Ave
Athens, GA 30606-2797 - Phone
- (706) 475-7000
- NPI assigned
- May 8, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Piedmont Athens Primary Care LLC
Piedmont Athens Hospitalist Physicians LLC
Practice addresses (Care Compare)
1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-7000
Hospital & facility affiliations
- Piedmont Athens Regional Medical Center
- Piedmont Walton Hospital
- Navicent Health Baldwin
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, 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 |
|---|---|---|---|---|
| I20230830001824 | MO | Practitioner - Internal Medicine | 9234504812 | Reassigns benefits to 3 organizations |
| I20250701004483 | GA | Practitioner - Internal Medicine | 9234504812 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104069 | GA | MD | Internal Medicine Physician |
| 2023027653 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospitals East Communities | Current |
Accepting new patients | |
| Piedmont Athens Primary Care LLC | Current |
Accepting new patients | |
| Mercy Clinic Adult Hospitalists- Jefferson, LLC | Internal Medicine | Current |
Accepting new patients |
| Mercy Hospitals East Communities | Current |
Accepting new patients | |
| Mercy Clinic Adult Hospitalists - Washington, LLC | Current |
Accepting new patients | |
| Piedmont Athens Hospitalist Physicians LLC | Internal Medicine | Current |
Accepting new patients |
| Piedmont Athens Regional Medical Center, Inc. | Past | Accepting new patients | |
| Piedmont Athens Specialty Care LLC | Past | Accepting new patients | |
| Mercy Hospital South | Past | Accepting new patients |
Locations
1270 Prince Ave
Ste 102
Athens, GA 30606
Phone (706) 475-9497
1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520
1199 Prince Ave
#70
Athens, GA 30606
Phone (706) 745-7055
2142 W Broad St
Bldg 200
Athens, GA 30606
Phone (706) 548-6881
1270 Prince Ave
Ste 201
Athens, GA 30606
Phone (470) 271-3427
1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111
615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075
615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687
10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328
901 E 5th St
Washington, MO 63090
Phone (636) 239-8000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2023027653 | MO | |
| Internal Medicine Physician | 207R00000X | 104069 | GA | Yes |
Addresses
Primary practice location
1199 Prince Ave
Athens, GA 30606-2797
Mailing address
1199 Prince Ave
Athens, GA 30606-2797
Other practice location 1
901 E 5th St
Washington, MO 63090-3127
Phone (636) 239-8231
Other practice location 2
1400 US Highway 61
Festus, MO 63028-4100
Phone (636) 933-5337
Other practice location 3
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6339
Other practice location 4
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1328
Other names
- Ms. Ibipo Muinat Otaiku
Other providers in Athens, GA
- A. J. Deutsch M.D. P.C.
- A.C.T. Home Care, Inc.
- Qirrat Saleem Aamir
- Abc Pediatric Therapy Partners, Inc.
- Abdulmoiz Kaiser Abdulwali
- Abhs Supported Emp
- Oluwamisimi Mary Abib
- Anis M Alkateb Abobaker
- Above and Beyond Home Care Cooperative, LLC
- Recto Abrigo
All providers in Athens, GA · Internal Medicine 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 Dec 24, 2025. 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.