Individual provider Active NPI

Brian Simba Simba, M.D

  • Nephrology Physician
  • Atlanta, GA
National Provider Identifier
1023464435
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
88688 Issued in GA
Practice address
3620 MLK Jr Dr SW
Atlanta, GA 30331-3711
Phone
(404) 696-7300
NPI assigned
May 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Nephrology Physician 207RN0300X 88688 GA Primary

Addresses

Primary practice location

3620 MLK Jr Dr SW
Atlanta, GA 30331-3711

Mailing address

3620 MLK Jr Dr SW
Atlanta, GA 30331-3711
Phone (404) 696-7300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.simba.1@16547.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210628001930 GA Practitioner - NephrologyPractitioner - Internal Medicine 9436484417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Atlanta Nephrology, PCGroup PAC ID 2062315088, 9 clinicians

Practice addresses (Care Compare)

3620 Martin Luther King Jr Dr SW
Atlanta, GA 30331-3711
Phone (404) 696-7300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Atlanta Nephrology, PC Nephrology CurrentSince Aug 16, 2021 Accepting new patients

Locations

3620 Martin Luther King Jr Dr SW
Atlanta, GA 30331
Phone (404) 696-7300

3620 Mlk Jr Dr SW
Atlanta, GA 30331
Phone (404) 696-7300

2669 Church St
East Point, GA 30344
Phone (404) 209-0113

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16547/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1023464435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 MLK JR DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303313711",
            "telephone_number": "404-696-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 MLK JR DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303313711",
            "telephone_number": "404-696-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMBA",
        "first_name": "BRIAN",
        "middle_name": "SIMBA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-05",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "88688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.simba.1@16547.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3620 Mlk Jr Dr SW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303313711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.