JACKSON DIALYSIS CENTER (NPI# 1033329198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033329198 |
| Entity Type | Organization |
| Organization Name | JACKSON DIALYSIS CENTER |
| Practice Address |
794 Mcdonough Rd Suite 108 Jackson GA 30233-1572 |
| Mailing Address |
Po Box 888 Jackson GA 30233-0019 |
| Practice Telephone | 7705049525 |
| Mailing Telephone | 7705049525 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BABATUNDE FARIYIKE (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7066478065 |
| 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 |
GA | Ambulatory Health Care Facilities |
| Street Address |
794 MCDONOUGH RD SUITE 108 |
| City | JACKSON |
| State | GA |
| Zip Code | 30233-1572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558330522 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 794 Mcdonough Rd, Jackson, GA 30233-1572 | 2006-03-14 |
| 1740755719 | Byron A Thompson | Counselor | 794 Mcdonough Rd, Jackson, GA 30233 | 2018-10-05 |
| 1750789947 | Select Interventional Pain, PC | Pain Medicine | 794 Mcdonough Rd, Suite 108, Jackson, GA 30233-1572 | 2014-12-20 |
| 1306126529 | Jaimi Marie Norrell | Nurse Practitioner | 794 Mcdonough Rd, 111, Jackson, GA 30233-1572 | 2011-08-18 |
| 1992943195 | Dana B Bass Burch | Physician Assistant | 794 Mcdonough Rd, Suite 111, Jackson, GA 30233-1572 | 2009-01-26 |
| 1093963944 | South Georgia Treatment, Inc | Clinic/Center | 794 Mcdonough Rd, Jackson, GA 30233-1572 | 2008-09-04 |
| 1306019104 | Bennie R White Jr Md Inc | Clinic/Center | 794 Mcdonough Rd, Suite 105, Jackson, GA 30233-1572 | 2008-04-12 |
| 1306025630 | Derrell Levohn Leggett | Anesthesiology | 794 Mcdonough Rd, Suite 108, Jackson, GA 30233-1572 | 2007-11-02 |
| 1376575225 | Bennie R. White Jr. | Family Medicine | 794 Mcdonough Rd, Suite 105, Jackson, GA 30233-1572 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366800914 | Georgia Ophthalmologists LLC | Durable Medical Equipment & Medical Supplies | 860 W 3rd St, Jackson, GA 30233 | 2016-02-10 |
| 1306225057 | Young Dreaden | Nurse Practitioner | 2978 Hwy 36w, Jackson, GA 30233 | 2015-05-28 |
| 1609255520 | Neta J Roby | Nurse Practitioner | Hwy 36, Georgia Diagnostic Classification Prison, Jackson, GA 30233 | 2015-05-26 |
| 1033546098 | Henrietta Lindsay | Social Worker | 463-b Ernest Biles Dr, Jackson, GA 30233 | 2013-10-04 |
| 1255776993 | Gareth Gene Walker | Technician | 514 Covinton Street, Jackson, GA 30233 | 2013-05-08 |
| 1730489592 | Mary L. Melton | Licensed Practical Nurse | 463 Ernest Biles Dr., Jackson, GA 30233 | 2010-10-27 |
| 1083864250 | Chastity Moore Brown | Dentist | 1520 Lucky Street, Griffin, GA 30233 | 2008-09-24 |
| 1568661320 | Joseph Fowlkes | Internal Medicine | 2978 Highway 36 W, Jackson, GA 30233 | 2007-07-12 |
| 1942386289 | Butts County Board of Commissioners | Ambulance | 154 Sylvan Drive, Jackson, GA 30233 | 2006-10-30 |
| 1841238300 | Jackson Pharmacy Services | Pharmacy | 22 Mulberry St., Jackson, GA 30233 | 2006-06-04 |
| Find all providers in zip 30233 | ||||
| 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 |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1417481755 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 656 N State St, Jackson, MS 39202-3303 | 2017-04-13 |
| 1619274610 | Total Renal Care Inc | Clinic/Center | 46 Harts Bridge Road, Jackson, TN 38301-0000 | 2011-02-28 |
| 1770711509 | Fresenius Medical Care Kidney and Hypertension, LLC | Clinic/Center | 128 N Elm Ave, Jackson, MI 49202-3502 | 2009-07-01 |
| 1720220213 | Ara-jackson Dialysis LLC | Clinic/Center | 3 Acy Ave, Suite B, Jackson, OH 45640-9561 | 2009-03-30 |
| 1912166778 | Bio-medical Applications of Ohio Inc | Clinic/Center | 820 Veterans Dr, Jackson, OH 45640-2411 | 2008-06-06 |
| 1548489149 | Synergy Dialysis Associates, LLC | Clinic/Center | 500 Mccarty Ln, Jackson, OH 45640 | 2007-04-24 |
| 1245324045 | Rai Care Centers of Michigan I, LLC | Clinic/Center | 200 South East Ave., Jackson, MI 49201-2414 | 2006-10-03 |
| 1013019215 | Bio-medical Applications of Kentucky, Inc. | Clinic/Center | 1550 Highway 15 S Ste 30, Jackson, KY 41339-9221 | 2006-09-01 |
| 1518079359 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 2995 Race St, Jackson, LA 70748-5839 | 2006-08-31 |
| Find all providers in JACKSON | ||||
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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.