GEORGIA NEPHROLOGY, LLC


Address: 2801 Candler Rd, Suite 203, Decatur, GA 30034-1423
Phone: 4042410402

GEORGIA NEPHROLOGY, LLC (NPI# 1619919966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619919966
Entity Type Organization
Organization Name GEORGIA NEPHROLOGY, LLC
Other Organization Name SOUTH DEKALB DIALYSIS CENTER
Practice Address 2801 Candler Rd
Suite 203
Decatur
GA 30034-1423
Practice Telephone 4042410402
Practice Fax Number 4043280232
Mailing Telephone 4042410402
Mailing Fax Number 4043280232
Enumeration Date 2006-06-12
Last Update Date 2020-08-22
Authorized Official Name ANDREW DIXON (OWNER/CEO)
Authorized Official Telephone 7709810558
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QE0700X Clinic/Center
Specialization: End-Stage Renal Disease (ESRD) Treatment
ESRD001212 GA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
GA 00963168A/B 05

Other Provider/Organization Names

Other Name Type Code
SOUTH DEKALB DIALYSIS CENTER Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1063422723 Georgia Nephrology, LLC Internal Medicine 497 Winn Way Ste A210, Decatur, GA 30030 2006-08-08

Office Location

Street Address 2801 CANDLER RD
SUITE 203
City DECATUR
State GA
Zip Code 30034-1423

Providers in the same location

NPI Name Taxonomy Address Enumeration
1952370876 Gege Odion Optometrist 2801 Candler Rd, Suite 66, Decatur, GA 30034-1427 2006-03-14
1174783252 Dr.gege Odion PC Optometrist 2801 Candler Rd, Suite 66, Decatur, GA 30034-1423 2008-06-12
1912188996 Optiworld Vision Center, LLC Eyewear Supplier (Equipment, not the service) 2801 Candler Rd, Suite 66, Decatur, GA 30034-1423 2007-11-19
1427154483 Dekalb County Board of Health Public Health or Welfare 2801 Candler Rd, Suite 67, Decatur, GA 30034-1423 2006-09-16

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1164916813 Lenina O Chi-ukpai Nurse Practitioner 2942 Secretariat Ct, Decatur, GA 30034 2018-06-17
1154662765 Zackery Kanel Thomas Driver 2782 Green Marsh Court, Decatur, GA 30034 2013-03-06
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1699096172 Wanda P Garrett Social Worker 3013 Rainbow Drive, Suite 112-e, South Dekalb Office Park, Decatur, GA 30034 2010-06-18
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Taxonomy Information

Taxonomy Code 261QE0700X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization End-Stage Renal Disease (ESRD) Treatment

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871080465 Renal Treatment Centers - Mid-atlantic Inc Clinic/Center 5360 Snapfinger Woods Dr Ste 102, Decatur, GA 30035-4046 2018-04-18
1396270906 Dialysis Services of Decatur LLC Clinic/Center 2705 Highway 31 S, Decatur, AL 35603-1507 2017-04-21
1760839922 Bio-medical Applications of Alabama, Inc. Clinic/Center 2834 Spring Ave Sw, Decatur, AL 35603-1218 2016-05-18
1295108983 Total Renal Care Inc Clinic/Center 2442 Wesley Chapel Rd, Decatur, GA 30035-3420 2015-11-04
1942672423 Odiorne Dialysis LLC Clinic/Center 2460 Wesley Chapel Rd, Ste 25d, Decatur, GA 30035-3420 2015-10-23
1699165290 Dsi Dekalb, LLC Clinic/Center 4570 Memorial Dr Ste B, Decatur, GA 30032-1444 2015-02-03
1972746204 Emory Dialysis, LLC Clinic/Center 2726 Candler Rd, Decatur, GA 30034-1410 2009-04-16
1962676155 Total Renal Care Inc Clinic/Center 5255 Snapfinger Park Dr Ste 115, Decatur, GA 30035-4066 2008-04-17
1871712927 Bio-medical Applications of Georgia, Inc. Clinic/Center 2721 Irvin Way, Decatur, GA 30030-1720 2007-04-25
1730242538 Decatur Hospital Authority Clinic/Center 2150 S Fm 51, Decatur, TX 76234 2006-12-19
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Competitor

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City DECATUR
Zip Code 30034

Improve Information

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Dataset Information

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.

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