North Georgia Kidney Specialists, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

036745 Issued in GA

Legal business name

NORTH GEORGIA KIDNEY SPECIALISTS, LLC

Practice address

880 Canton Rd NE
Suite 400
Marietta, GA 30060-7283

Phone

(770) 528-9788

Fax

(770) 420-2229

NPI assigned

Sep 14, 2006

Last updated

Jul 15, 2013By 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. Manolo S Gallego, M.D.NPI 1275520793

Title

President/Physician

Phone

(770) 528-9788

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Manolo Gallego, M.D.

  • Nephrology Physician
  • Marietta, GA
  • NPI 1275520793
  Medicare reassignment Care Compare group NPD Authorized official
• Salvatore Chillemi, MD

  • Nephrology Physician
  • Marietta, GA
  • NPI 1285839431
  Medicare reassignment Care Compare group NPD
• Jalal Eddin Hakmei, M.D.

  • Nephrology Physician
  • Marietta, GA
  • NPI 1730468570
  Medicare reassignment Care Compare group NPD
• Muhammad Jabri, MD

  • Nephrology Physician
  • Marietta, GA
  • NPI 1285688283
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373846400000",
    "number": "1053416925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 CANTON RD NE",
            "address_2": "SUITE 400",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607283",
            "telephone_number": "770-528-9788",
            "fax_number": "770-420-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 CANTON RD NE",
            "address_2": "SUITE 400",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607283",
            "telephone_number": "770-528-9788",
            "fax_number": "770-420-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GEORGIA KIDNEY SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2013-07-15",
        "status": "A",
        "authorized_official_last_name": "GALLEGO",
        "authorized_official_first_name": "MANOLO",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "770-528-9788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "036745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000960726F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GALLEGO INDIVIDUAL NPI",
            "identifier": "1275520793",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MUHAMMAD YASSER JABRI, M.D. INDIVIDUAL NPI #",
            "identifier": "1285688283",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233167541A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282117409A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP #",
            "identifier": "DD6106",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00691182AB",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "555189352A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.