Central Georgia Dialysis LLC

Primary specialty

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

License

ESRD001047 Issued in GA

Legal business name

CENTRAL GEORGIA DIALYSIS LLC

Practice address

165 Emery Hwy Ste 101
Macon, GA 31217-3617

Phone

(478) 755-1144

Fax

(478) 755-1127

NPI assigned

Mar 17, 2006

Organization subpart

No

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

Authorized official

Name

Samuel T Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• East Macon Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Central Georgia Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Perry, GA
  • NPI 1922076108

  8527083310

  Same PAC ID

Listed as

DaVita East Macon Dialysis CenterCCN 112602

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Nov 15, 2000

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

24

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

CLIA laboratory certificates

Tax ID family

Central Georgia Dialysis LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Central Georgia Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Perry, GA
  • NPI 1922076108
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Renal Treatment Centers Mid Atlantic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Goldsboro, NC
  • NPI 1174086698

  Member Of

  NPD member

Locations

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Carlos O Martinez, M.D.

  • Nephrology Physician
  • Macon, GA
  • NPI 1841368933

  Dialysis facility

  Care Compare affiliation Name & address match
• Navin Taneja, M.D.

  • Nephrology Physician
  • Warner Robins, GA
  • NPI 1073538088

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1073582425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 EMERY HWY STE 101",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173617",
            "telephone_number": "478-755-1144",
            "fax_number": "478-755-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL GEORGIA DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "GA",
            "license": "ESRD001047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110252752A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Macon Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Macon Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Central Ga Head &Neck Surgery Center
• Central Ga Women'S Health Center 2 LLC
• Central Georgia Adult Day Health & Rehab, Inc
• Central Georgia Cancer Care
• Central Georgia Cancer Care
• Central Georgia Emergency Group, LLC
• Central Georgia Eye Designs, Inc.
• Central Georgia Foot and Ankle Center PC
• Central Georgia Gastroenterology, LLC
• Central Georgia Gynecology II LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Macon, GA
• Providers in Macon, 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 Jul 1, 2025; 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.