NPIMap

Organization Active NPI

Aegis Nephrology & Internal Medicine, LLC

  • Nephrology Physician
  • Warner Robins, GA
National Provider Identifier
1043485352
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
052234 Issued in GA
Legal business name
AEGIS NEPHROLOGY & INTERNAL MEDICINE, LLC
Practice address
130 Hospital Dr
Warner Robins, GA 31088-4204
Phone
(478) 225-9983
Fax
(478) 225-9891
NPI assigned
Apr 28, 2008
Last updated
Nov 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Authorized official

Name
Navin Taneja, M.D.NPI 1073538088
Title
Owner/Physician
Phone
(478) 225-9983

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 052234 GA
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X 052234 GA
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 052234 GA Primary

Addresses

Primary practice location

130 Hospital Dr
Warner Robins, GA 31088-4204

Mailing address

130 Hospital Dr
Warner Robins, GA 31088-4204
Phone (478) 225-9983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080717000122 GA Part B Supplier - Clinic/Group Practice 9638242175 Receives reassigned benefits from 1 practitioner
Practice locations: Perry, GA; Warner Robins, GA

National Provider Directory

National Provider Directory

Locations

130 Dr Parihar Dr
Warner Robins, GA 31088

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1043485352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HOSPITAL DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310884204",
            "telephone_number": "478-225-9983",
            "fax_number": "478-225-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HOSPITAL DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310884204",
            "telephone_number": "478-225-9983",
            "fax_number": "478-225-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS NEPHROLOGY & INTERNAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "TANEJA",
        "authorized_official_first_name": "NAVIN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "478-225-9983",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "052234",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "052234",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "052234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.