Organization Active NPI

Swainsboro Dialysis Clinic LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Swainsboro, GA
National Provider Identifier
1104224054
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SWAINSBORO DIALYSIS CLINIC LLC
Practice address
3 Medical Center Dr
Swainsboro, GA 30401-5777
Phone
(478) 237-8186
Fax
(478) 237-4119
NPI assigned
Dec 9, 2014
Last updated
Jul 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Authorized official

Name
Sara Anne Brady
Title
Chief Nursing Officer
Phone
(208) 371-7878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

3 Medical Center Dr
Swainsboro, GA 30401-5777

Mailing address

3 Medical Center Dr
Swainsboro, GA 30401-5777
Phone (478) 237-8186

Other identifiers 1

IdentifierTypeStateIssuer
000814184EMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150211001044 GA Part A Provider - End-Stage Renal Disease Facility (ESRD) 2163747395 Practice locations: Swainsboro, GA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Swainsboro Dialysis Clinic, LLCCCN 112664
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Sep 8, 1999
Medicare certification status
ActiveFrom the Provider of Services file
Chain
American Renal Associates
Dialysis stations
11

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0960347Swainsboro Dialysis Clinic ,LLC3 Medical Center Drive, Swainsboro, GA 30401Certificate of waiverMay 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Rai Care Centers of Georgia I 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.

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.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784246400000",
    "number": "1104224054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MEDICAL CENTER DR",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304015777",
            "telephone_number": "478-237-8186",
            "fax_number": "478-237-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL CENTER DR",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304015777",
            "telephone_number": "478-237-8186",
            "fax_number": "478-237-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWAINSBORO DIALYSIS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-09",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CHIEF NURSING OFFICER",
        "authorized_official_telephone_number": "208-371-7878"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000814184E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Swainsboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.