Jackson Dialysis Center

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

JACKSON DIALYSIS CENTER

Practice address

794 McDonough Rd
Suite 108
Jackson, GA 30233-1572

Phone

(770) 504-9525

NPI assigned

May 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Babatunde FariyikeNPI 1265436760

Title

Medical Director

Phone

(706) 647-8065

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Babatunde Tenitayo Fariyike, MD

  • Nephrology Physician
  • Thomaston, GA
  • NPI 1265436760
  Authorized official Same address or phone

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033329198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302330019",
            "telephone_number": "770-504-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 MCDONOUGH RD",
            "address_2": "SUITE 108",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331572",
            "telephone_number": "770-504-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON DIALYSIS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FARIYIKE",
        "authorized_official_first_name": "BABATUNDE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "706-647-8065",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Honorable Homecare LLC
• Household of Faith
• Shawn Edward Humphries, MPT
• I -Net International LLC
• Integrity Rehab Management (Integrity Diagnostics)
• Jackson Ga Opco LLC (Westbury Center of Jackson for Nursing and Healing)
• Jackson Pharmacy Services
• Joshua Michael Jacobson
• Leslie Diane Jarrett, NP
• Nicole Pritchett Jimerson, DO

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Jackson, GA
• Providers in Jackson, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.