DR. SALLY WILLIAMS IWAMOTO M.D.
NPI 1285193300
Student in an Organized Health Care Education/Training Program in Atlanta, GA

Active since March 18, 2019PECOS EnrolledAccepts Medicare Assignment
12 EXECUTIVE PARK DR NE, ATLANTA, GA 30329(404) 778-7777 Get Directions Write a Review

NPPES record last updated: August 7, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 7, 2023, Apr 14, 2023, Mar 18, 2019 (3 updates tracked since 2019).

About Dr. Sally Williams Iwamoto M.d. NPPES

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

DR. SALLY WILLIAMS IWAMOTO M.D. (NPI 1285193300) is an individual student in an organized health care education/training program in Atlanta, Georgia and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS, is affiliated with Emory University Hospital, and is a graduate of Boston University School Of Medicine (2019).

NPPES Registry Identity

NPI1285193300
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. SALLY WILLIAMS IWAMOTOCredential: M.D.
Location Address12 EXECUTIVE PARK DR NEAtlanta, GA 30329
Mailing Address12 Executive Park Dr NeAtlanta, GA 30329 · (404) 778-7777
Sole ProprietorNo
Medical School CMSBoston University School Of MedicineGraduated 2019
Enumeration DateMarch 18, 2019
Last NPPES UpdateAugust 7, 20233 updates tracked since enumeration
NPPES CertifiedAugust 7, 2023
NPI 1285193300 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License 96257 (GA)
12 EXECUTIVE PARK DR NE, Atlanta, GA 30329

Other Names 1

Former Name (1)Dr. Sally Rebecca Williams M.d.

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. Sally Williams Iwamoto 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 ID7911233663
PECOS Enrollment IDI20230913002453
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
31 services27 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
28 services26 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Emory University Hospital

Acute Care Hospitals · Atlanta, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110010
Location1364 Clifton Road, NEAtlanta, GA 30322 · De Kalb County
Emergency services

Emory University Hospital Midtown

Acute Care Hospitals · Atlanta, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110078
Location550 Peachtree Street, NEAtlanta, GA 30308 · Fulton County
Emergency services Birthing friendly

Emory Johns Creek Hospital

Acute Care Hospitals · Johns Creek, GA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number110230
Location6325 Hospital ParkwayJohns Creek, GA 30097 · Gwinnett County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Child & Adolescent Psychiatry)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Social Worker (Clinical)
12 EXECUTIVE PARK DR NE, 5TH FLOOR
ATLANTA, GA 30329
Psychiatry & Neurology (Sleep Medicine)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Social Worker (Clinical)
12 EXECUTIVE PARK DR NE, INTEGRATED MEMORY CARE - 5TH FLOOR COGNITIVE NEUROLOGY
ATLANTA, GA 30329
Nurse Practitioner (Adult Health)
12 EXECUTIVE PARK DR NE, 4TH FLOOR
ATLANTA, GA 30329
Nurse Practitioner (Family)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Student in an Organized Health Care Education/Training Program
12 EXECUTIVE PARK DR NE, SUITE 331
ATLANTA, GA 30329
Nurse Practitioner (Gerontology)
12 EXECUTIVE PARK DR NE, SUITE 504
ATLANTA, GA 30329

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285193300, enumerated as an "individual" on March 18, 2019.

The provider is located at 12 EXECUTIVE PARK DR NE ATLANTA, GA 30329 and the phone number is (404) 778-7777.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Sally Iwamoto is affiliated with: EMORY UNIVERSITY HOSPITAL, EMORY UNIVERSITY HOSPITAL MIDTOWN and EMORY JOHNS CREEK HOSPITAL.