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DR. ELLIS IFEANYICHUKWU EFOBI M.D.
NPI 1144487018
General Practice in Stone Mountain, GA

Active since May 19, 2008PECOS EnrolledAccepts Medicare Assignment
1525 E. PARK PLACE BLVD., SUITE 300, STONE MOUNTAIN, GA 30087(770) 879-7707(770) 879-7708 Get Directions Write a Review

NPPES record last updated: February 2, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Ellis Ifeanyichukwu Efobi M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ELLIS IFEANYICHUKWU EFOBI M.D. (NPI 1144487018) is an individual general practice provider in Stone Mountain, Georgia, licensed in Georgia (060727) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS and is a graduate of Other (1979).

NPPES Registry Identity

NPI1144487018
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. ELLIS IFEANYICHUKWU EFOBICredential: M.D.
Location Address1525 E. PARK PLACE BLVD., SUITE 300Stone Mountain, GA 30087-3453
Mailing Address1525 E. Park Place Blvd., Suite 300Stone Mountain, GA 30087-3453 · (770) 879-7707 · Fax (770) 879-7708
Phone(770) 879-7707
Fax(770) 879-7708
Sole ProprietorNo
Medical School CMSOtherGraduated 1979
Enumeration DateMay 19, 2008
Last NPPES UpdateFebruary 2, 2011
✔ NPI 1144487018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in GA · 060727
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedPhysical Medicine & Rehabilitation · Pain MedicineTaxonomy 2081P2900X · License 060727 (GA)
1525 E. PARK PLACE BLVD., Stone Mountain, GA 30087
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Other Identifiers 1

Medicaid594981959AGA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ellis Ifeanyichukwu Efobi M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8426185984
PECOS Enrollment IDI20100415000312
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ellis Efobi's NPI number?

The NPI number for Ellis Efobi is 1144487018. It was assigned to this individual provider in the NPPES registry on May 19, 2008.

Where is Ellis Efobi located?

Ellis Efobi practices at 1525 E. Park Place Blvd. Suite 300, Stone Mountain, GA 30087. The listed phone number is (770) 879-7707.

What is Ellis Efobi's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Ellis Efobi enrolled in Medicare?

Yes. Ellis Efobi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Ellis Efobi was last updated on February 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.