Southwest Ga. Nephrology Clinic, P.C.
Organization Active NPI Specialist · Albany, GA
NPI 1104015569 · NPPES record last updated Aug 5, 2015
Key facts
- NPI
- 1104015569
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- H708815 (GA)
- Legal business name
- SOUTHWEST GA. NEPHROLOGY CLINIC, P.C.
- Practice address
- 1200 N Jefferson St
Albany, GA 31701-2057 - Phone
- (229) 888-3970
- Fax
- (229) 889-9386
- NPI assigned
- Oct 22, 2007
- Organization subpart
- No
Authorized official
- Name
- John J. Schilling, M.D.
- Title
- President
- Phone
- (229) 888-3970
Other NPIs on the same Medicare enrollment 1
Practitioners 14
-
Ismail Abubakar Ibrahim, MBBS
-
Monalyn Andres Balote, AGNP-C
-
Salim Bou Slaiman, M.D
-
John A Dennis, PA-C
-
Marquisha Hines, NP
-
Chantileer Jackson, APN
-
Jeffrey L Bell, MD
-
Julie A. Isaac, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040520000101 | GA | Part B Supplier - Clinic/Group Practice | 3779574686 |
Receives reassigned benefits from 13 practitioners 1 other NPI on this enrollment Practice locations: Albany, GA |
National Provider Directory
Locations
1921 W Oakridge Dr
Albany, GA 31707
Phone (229) 435-9295
1200 N Jefferson St
Ste B
Albany, GA 31701
Phone (229) 888-3970
650 Pointe North Blvd
Albany, GA 31721
Phone (229) 888-8015
210 Park St
Leesburg, GA 31763
Phone (229) 759-1998
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | H708815 | GA | Yes |
Addresses
Primary practice location
1200 N Jefferson St
Albany, GA 31701-2057
Mailing address
1200 N Jefferson St
Suite B
Albany, GA 31701-2057
Phone (229) 888-3970
Other providers in Albany, GA
- Southern Surgery Center, LLC
- Southland Children'S Dentistry LLC
- Southwest Ga Health District 8 Unit 2 BCW
- Southwest Ga Health District 8 Unit 2 CMS
- Southwest Ga Health District 8 Unit 2 HIV AIDS
- Southwest Georgia Anesthesia Consultants, LLC
- Southwest Georgia Anesthesiologist LLC
- Southwest Georgia Association for Aging and Convalescent Persons
- Southwest Georgia Dermatology, P.C.
- Southwest Georgia Medical Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2015. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.