CENTRAL GEORGIA DIALYSIS LLC (NPI# 1922076108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922076108 |
Entity Type | Organization |
Organization Name | CENTRAL GEORGIA DIALYSIS LLC |
Other Organization Name | PERRY DIALYSIS CENTER |
Practice Address |
1027 Keith Dr Perry GA 31069 |
Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
Practice Telephone | 4789877120 |
Practice Fax Number | 4789883095 |
Mailing Telephone | 6153204268 |
Mailing Fax Number | 8772380567 |
Enumeration Date | 2006-03-14 |
Last Update Date | 2018-07-25 |
Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
Authorized Official Telephone | 2537334500 |
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 |
ESRD001177 | GA | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 000878435A | 05 |
Other Name | Type Code |
---|---|
Perry Dialysis Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073582425 | Central Georgia Dialysis LLC | Clinic/Center | 165 Emery Hwy, Suite 101, Macon, GA 31217 | 2006-03-17 |
Street Address |
1027 KEITH DR |
City | PERRY |
State | GA |
Zip Code | 31069 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386114924 | Rebecca Lyn Parker | Pharmacist | 302 Walton Chase, Perry, GA 31069 | 2018-11-27 |
1437637568 | Joshua Thomas Guley | Dentist | 2161 Houston Lake Road Hwy 127, Perry, GA 31069 | 2018-07-31 |
1043755531 | Otha Everett | Counselor | 733-b Carroll Street, Perry, GA 31069 | 2016-12-20 |
1699226001 | Middle Georgia Primary Care | Nurse Practitioner | 1115 Morningside Drive, Perry, GA 31069 | 2016-10-20 |
1639535628 | Holly Lavender | Nurse Practitioner | 1016 Keith Dr, Perry, GA 31069 | 2016-01-07 |
1598049918 | Spencer D Shugart | Physical Therapist | 1202 Macon Rd, Perry, GA 31069 | 2011-10-04 |
1154638518 | Middle Georgia Anesthesiology, LLC | Nurse Anesthetist, Certified Registered | 1040 Morningside Drive, Perry, GA 31069 | 2010-09-07 |
1922203686 | Sarah Pearson Velasquez | Nurse Practitioner | 1024 Keith Drive, Perry, GA 31069 | 2007-06-20 |
1417008004 | Bruce Duwayne Sampson | Internal Medicine | 1019 Keith Drive, Suite A, Perry, GA 31069 | 2007-01-12 |
1104839125 | Harold Brian Gillis | Chiropractor | 1207 Main Street Suite C, Perry, GA 31069 | 2006-08-14 |
Find all providers in zip 31069 |
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 |
---|---|---|---|---|
1508959172 | Renal Treatment Centers Illinois Inc | Clinic/Center | 610 10th St Ste L100, Perry, IA 50220 | 2006-10-02 |
1972571206 | Dva Healthcare Renal Care, Inc. | Clinic/Center | 118 W Main St, Perry, FL 32347-2656 | 2006-03-11 |
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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 |
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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.