SPALDING COUNTY DIALYSIS, LLC (NPI# 1023058898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023058898 |
| Entity Type | Organization |
| Organization Name | SPALDING COUNTY DIALYSIS, LLC |
| Practice Address |
1570 Williamson Rd Griffin GA 30224-3931 |
| Mailing Address |
3588 Highway 138 Se Pmb 344 Stockbridge GA 30281-4171 |
| Practice Telephone | 7704678116 |
| Practice Fax Number | 7704678116 |
| Mailing Telephone | 7704678116 |
| Mailing Fax Number | 7704678795 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MOHAMAD MOUSSA KASSEM (PRESIDENT) |
| Authorized Official Telephone | 7704678116 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
ESRD001194 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00946613A | 05 |
| Street Address |
1570 WILLIAMSON RD |
| City | GRIFFIN |
| State | GA |
| Zip Code | 30224-3931 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346888971 | Latamika Renee Williams | Counselor | 1710 Ga-16 West, #6, Griffin, GA 30224 | 2019-12-13 |
| 1063062651 | Dominique S Paul-thompson | Contractor | 112 Deercreek Parkway, Griffin, GA 30224 | 2019-09-16 |
| 1497303531 | Xiaohui Zhang Brotzge | Physician Assistant | 601 S 8th Street, Griffin, GA 30224 | 2019-09-02 |
| 1548812282 | Andrew Dennis Nesmith | Registered Nurse | 601 South 8th St, Emergency Room, Griffin, GA 30224 | 2019-07-12 |
| 1073009122 | Alicia Skye Ledford | Nurse Practitioner | 619 S 8th St., Suite 200, Griffin, GA 30224 | 2018-07-02 |
| 1649787102 | Judith Fuajong Ngulefac | Nurse Practitioner | 1705 Williamson Rd, Griffin, GA 30224 | 2018-01-05 |
| 1699297077 | Amanda Norman | Speech-Language Pathologist | 106 Garnet Ln, Griffin, GA 30224 | 2017-07-07 |
| 1306214655 | Ruchi P Gandhi | Optometrist | 646 8th Street, Griffin, GA 30224 | 2015-09-03 |
| 1528473881 | Nnenna Ezeilo | Otolaryngology | 619 S 8th St Ste 304, Griffin, GA 30224 | 2014-06-25 |
| 1437436094 | C. B. Reddy Md PC | Preferred Provider Organization | 610 S 8th Street, Suite F, Griffin, GA 30224 | 2011-11-10 |
| Find all providers in zip 30224 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629322557 | Renal Carepartners of Griffin LLC | Clinic/Center | 1837 W Mcintosh Rd, Griffin, GA 30223-1787 | 2012-10-30 |
| 1922077965 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 731 S 8th St, Griffin, GA 30224-4818 | 2006-03-14 |
| 1992774939 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 521 N Expressway Ste 1509, Griffin, GA 30223-2073 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871190207 | Usrc Powder Springs Home LLC | Clinic/Center | 3721 New Macland Rd Ste 100b, Powder Springs, GA 30127-2000 | 2020-10-08 |
| 1083229280 | Bio- Medical Applications of Georgia, Inc. | Clinic/Center | 145 W Hendry St, Hinesville, GA 31313-3201 | 2020-09-14 |
| 1336759463 | Plattaz Dialysis, LLC | Clinic/Center | 100 Promenade Pkwy Ste C, Fayetteville, GA 30214-7735 | 2020-08-04 |
| 1174140743 | Home Dialysis Services Norcross LLC | Clinic/Center | 3780 Holcomb Bridge Rd Ste E, Norcross, GA 30092-4877 | 2020-06-30 |
| 1265058275 | Dialysis Care Center Pleasant Hill LLC | Clinic/Center | 1425 Georgia Ave Ste 102, Macon, GA 31201-6546 | 2020-06-25 |
| 1598389132 | Concerto Georgia LLC | Clinic/Center | 655 Exchange Cir Ste 100, Bethlehem, GA 30620-1767 | 2020-05-29 |
| 1629607098 | Rutledge Dialysis, LLC | Clinic/Center | 1719 New Hope Rd, Lawrenceville, GA 30045-6570 | 2020-04-07 |
| 1215562293 | Dialysis Clinic Inc | Clinic/Center | 1219 S. Martin Luther King Blvd., Americuse, GA 31719 | 2020-03-10 |
| 1659915882 | Filmore Dialysis, LLC | Clinic/Center | 4555 Atlanta Hwy Ste M, Loganville, GA 30052-2646 | 2019-10-31 |
| 1013562818 | Menca Dialysis, LLC | Clinic/Center | 3030 Headland Dr Sw Ste C, Atlanta, GA 30311-5435 | 2019-08-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.