Atlanta Kidney and Hypertension Associates
Organization Active NPI Nephrology Physician · Austell, GA
NPI 1083649552 · NPPES record last updated Apr 19, 2022
Key facts
- NPI
- 1083649552
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 055949 (GA)
- Legal business name
- ATLANTA KIDNEY AND HYPERTENSION ASSOCIATES
- Practice address
- 1810 Mulkey Rd
Suite 103
Austell, GA 30106-1151 - Phone
- (770) 732-8464
- Fax
- (770) 732-8462
- NPI assigned
- Jul 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Traci Evett
- Title
- Billing Coordinator
- Phone
- (678) 247-1434
Practitioners 5
-
Mini Gupta, MD
-
Jyoti Sharma, MD
-
Janda' Hill, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D1053467 | Atlanta Kidney and Hypertension Associates | Provider-performed microscopy | Apr 1, 2028 |
| 11D1095730 | Atlanta Kidney and Hypertension Associates | Provider-performed microscopy | Feb 16, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060801000197 | GA | Part B Supplier - Clinic/Group Practice | 6608889043 |
Receives reassigned benefits from 4 practitioners Practice locations: Hiram, GA; Austell, GA |
National Provider Directory
Locations
1899 Lake Rd
Ste 111
Hiram, GA 30141
Phone (770) 732-8464
Interoperability endpoints
- https://api.platform.athenahealth.com/3666/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician |
207RN0300X | 055949 | GA | Yes |
Addresses
Primary practice location
1810 Mulkey Rd
Suite 103
Austell, GA 30106-1151
Mailing address
1810 Mulkey Rd
Suite 103
Austell, GA 30106-1151
Phone (770) 732-8464
Other practice location 1
1899 Lake Rd Ste 111
Hiram, GA 30141-2292
Phone (770) 732-8464
Other providers in Austell, GA
- Oyebimpe Glory Aroniyo
- Michelle Arrington-Myers
- Ashish Kapila DPM
- Saad Aslam
- Assurance Wellness LLC
- Atlanta Prosthetics & Orthotics, Inc.
- Atlanta West Dermatology & Surgery Center PC
- Atlanta West Family Dentistry
- Attention Consulting Services LLC
- Kate Elizabeth Aufort
All providers in Austell, GA · Nephrology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.