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WATERFALLS MEDICAL PRACTICE, P.C
NPI 1225567225
Internal Medicine in Peachtree City, GA

Active since June 05, 2017
112 GOVERNORS SQ STE B, PEACHTREE CITY, GA 30269(678) 932-8112(678) 932-8113 Get Directions Write a Review

NPPES record last updated: June 16, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 16, 2020, Jun 5, 2017 (2 updates tracked since 2017).

About Waterfalls Medical Practice, P.c NPPES

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

WATERFALLS MEDICAL PRACTICE, P.C (NPI 1225567225) is a healthcare organization registered as an internal medicine in Peachtree City, Georgia and active in the NPI registry since June 2017. The organization maintains a secondary practice location in Peachtree City and lists Irene Ayoyinka Omotoso, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1225567225
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameWATERFALLS MEDICAL PRACTICE, P.C
Location Address112 GOVERNORS SQ STE BPeachtree City, GA 30269-4864
Mailing Address1202 Tolmount CtPeachtree City, GA 30269-3348 · (678) 932-8112 · Fax (678) 932-8113
Phone(678) 932-8112
Fax(678) 932-8113
Organization SubpartNo
Authorized OfficialIrene Ayoyinka OmotosoMedical Director · (678) 932-8112
Enumeration DateJune 5, 2017
Last NPPES UpdateJune 16, 20202 updates tracked since enumeration
NPPES CertifiedJune 16, 2020
✔ NPI 1225567225 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 053629
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
112 GOVERNORS SQ STE B, Peachtree City, GA 30269
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Secondary Practice Location 1

Location 11202 Tolmount CtPeachtree City, GA 30269-3348 · Phone (678) 932-8112 · Fax (678) 932-8113

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Waterfalls Medical Practice, P.c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Waterfalls Medical Practice, P.C, which bills Medicare for the services this clinician delivers.

Clinician (1)

Irene Omotoso, MD
Internal Medicine
NPI 1205848785
112 GOVERNORS SQ STE B
Peachtree City, GA 30269
(678) 932-8112
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Waterfalls Medical Practice, P.C's NPI number?

The NPI number for Waterfalls Medical Practice, P.C is 1225567225. It was assigned to this organization in the NPPES registry on June 5, 2017.

Where is Waterfalls Medical Practice, P.C located?

Waterfalls Medical Practice, P.C is located at 112 Governors Sq Ste B, Peachtree City, GA 30269. The listed phone number is (678) 932-8112.

What is Waterfalls Medical Practice, P.C's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Waterfalls Medical Practice, P.C enrolled in Medicare?

Yes. Waterfalls Medical Practice, P.C is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Waterfalls Medical Practice, P.C?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Waterfalls Medical Practice, P.C. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Waterfalls Medical Practice, P.C was last updated on June 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.