NPIMap

Individual provider Active NPI

Dominic Ikwume Asika, M.D

  • Emergency Medicine Physician
  • Douglasville, GA
National Provider Identifier
1992749113
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
031871 Issued in GA
Practice address
9280 Highway 5 Ste E
Douglasville, GA 30134-1501
Phone
(770) 635-8163
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1976
Medicare assignment
May accept Medicare assignment
Group practices
Prime Immediate Care LLC 2 clinicians

Practice addresses (Care Compare)

9280 Hwy 5 E
Douglasville, GA 30134-1501
Phone (770) 635-8163

Hospital & facility affiliations

  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040602001328 GA Practitioner - Emergency Medicine 2769464825 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Immediate Care LLC CurrentSince Oct 1, 2007 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine Past Accepting new patients
TMC Immediate Care, Inc PastSince Oct 1, 2007 Accepting new patients
Sterling Emergency Services of Virginia Inc Emergency Medicine Past Accepting new patients
Sterling Emergency Services of the Southeast Inc Emergency Medicine Past Accepting new patients
Riverside Emergency Physicians LLP Emergency Medicine Past Accepting new patients
North Georgia Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Inphynet Primary Care Physicians Southeast PC Emergency Medicine Past Accepting new patients
Ecs of Virginia, Inc. Emergency Medicine Past Accepting new patients

Locations

9280 Highway 5
Ste E
Douglasville, GA 30134
Phone (770) 635-8163

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 031871 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

9280 Highway 5 Ste E
Douglasville, GA 30134-1501

Mailing address

9280 Highway 5
Ste E
Douglasville, GA 30134-1501
Phone (770) 635-8163

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
000406777ZMedicaidGA
000406777YMedicaidGA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 24, 2024.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1992749113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9280 HIGHWAY 5",
            "address_2": "STE E",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341501",
            "telephone_number": "770-635-8163",
            "fax_number": "770-635-8254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9280 HIGHWAY 5 STE E",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341501",
            "telephone_number": "770-635-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASIKA",
        "first_name": "DOMINIC",
        "middle_name": "IKWUME",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "031871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000406777Z",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000406777Y",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.