SOUTH AUGUSTA DIALYSIS CLINIC LLC (NPI# 1356749212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356749212 |
| Entity Type | Organization |
| Organization Name | SOUTH AUGUSTA DIALYSIS CLINIC LLC |
| Practice Address |
3206 Peach Orchard Rd Augusta GA 30906-3540 |
| Practice Telephone | 7067985774 |
| Practice Fax Number | 7067963465 |
| Mailing Telephone | 7067985774 |
| Mailing Fax Number | 7067963465 |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2020-03-13 |
| Authorized Official Name | SHARI K COUSINS (SR. VP OF CLINICAL & REGULATORY) |
| Authorized Official Telephone | 9789223080 |
| 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 |
Ambulatory Health Care Facilities |
| Street Address |
3206 PEACH ORCHARD RD |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30906-3540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508978313 | Bio-medical Applications of Georgia, Inc. | Clinic/Center | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2006-08-31 |
| 1790399434 | Fabian Azofeifa | Physical Therapist | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2020-09-01 |
| 1285281881 | Austin Hamilton Ramos | Physical Therapist | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2019-08-20 |
| 1578124087 | Katie Riegelman | Physical Therapist | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2019-06-25 |
| 1174092563 | Andrew Phan | Physical Therapist | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2018-11-15 |
| 1487178646 | Jonathan Eidman | Physical Medicine & Rehabilitation | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2017-07-31 |
| 1629430533 | Ashly Nicole Marie Westfield-white | Physical Therapist | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2016-03-22 |
| 1891165106 | Michelle R Martin | Physical Therapy Assistant | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2015-09-29 |
| 1629409941 | Travis A Greene | Physical Therapist | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2013-12-12 |
| 1457606485 | Kaitlin Mcclure Merwin | Physical Therapist | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2012-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969432 | Barton Chapel Dental Group, LLC | Dentist | 2755 Barton Chapel Road, Augusta, GA 30906 | 2020-04-01 |
| 1255897419 | Pediatric Mobility Innovations | Durable Medical Equipment & Medical Supplies | 3114 Augusta Tech Drive Suite 404, Augusta, GA 30906 | 2019-02-13 |
| 1023539731 | Kristy Lee Gibbs | Registered Nurse | 3421 Mike Padgett Hwy Bldg C, Augusta, GA 30906 | 2017-07-03 |
| 1194186031 | Clifton Nane Williams | Counselor | 3230 Hampton Circle, Augusta, GA 30906 | 2016-03-18 |
| 1376929661 | Catherine A. Ganzy | Social Worker | 3405 Mike Padgett Highway; Building 201, East Central Regional Hosptial, Augusta, GA 30906 | 2015-08-10 |
| 1962810358 | Fatemeh Azadeh Paziraei | Dentist | 1631 Gordon Highway, Augusta Smiles Youth Dentistry, Augusta, GA 30906 | 2014-07-29 |
| 1568809770 | Brandon Jennings | Occupational Therapy Assistant | 2388 Old Mcduffie Rd, Augusta, GA 30906 | 2013-05-29 |
| 1811266646 | Eddie P Johnson IIi, Dmd, PC | Preferred Provider Organization | 2755 Barton Chapel Rd, Augusta, GA 30906 | 2011-12-23 |
| 1366739021 | Kerensa A Cooks | Registered Nurse | 3421 Mike Padgett Highway, Serenity Behavioral Health Systems, Augusta, GA 30906 | 2011-07-01 |
| 1265737423 | Pidcock Chiropractic, Inc. | Chiropractor | 3028 Peach Orchard Rd., Augusta, GA 30906 | 2011-01-20 |
| Find all providers in zip 30906 | ||||
| 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 |
|---|---|---|---|---|
| 1225412513 | Bio-medical Applications of Georgia, Inc. | Clinic/Center | 2470 Wrightsboro Rd, Augusta, GA 30904-6202 | 2015-07-16 |
| 1235370164 | Rai Care Centers of Georgia I LLC | Clinic/Center | 1719 Magnolia Way, Augusta, GA 30909-9482 | 2009-03-24 |
| 1225140056 | Bio-medical Applications of Georgia, Inc. | Clinic/Center | 1717 Walton Way, Augusta, GA 30904-3705 | 2006-08-31 |
| 1508978313 | Bio-medical Applications of Georgia, Inc. | Clinic/Center | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2006-08-31 |
| 1316059140 | Bio-medical Applications of Georgia Inc | Clinic/Center | 1109 Medical Center Dr Bldg H, Augusta, GA 30909-6669 | 2006-08-31 |
| 1063438042 | Bio-medical Applications of Maine, Inc. | Clinic/Center | 164 Civic Center Dr, Augusta, ME 04330-8028 | 2006-07-14 |
| 1255373437 | Ara-south Augusta Clinic LLC | Clinic/Center | 1649 Gordon Hwy, Augusta, GA 30906-2220 | 2006-06-12 |
| 1073560611 | Nra-augusta, Georgia, LLC | Clinic/Center | 2841 Deans Bridge Rd, Augusta, GA 30906-2704 | 2006-05-28 |
| 1194772947 | Ara-augusta Clinic LLC | Clinic/Center | 1000 Telfair St, Augusta, GA 30901-2208 | 2006-05-27 |
| 1972572949 | Dva Healthcare Renal Care Inc | Clinic/Center | 1815 Wylds Rd, Augusta, GA 30909-4430 | 2006-03-14 |
| Find all providers in AUGUSTA | ||||
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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.