Individual provider Active NPI

Hamid Reza Chimeh, M.D.

  • Nephrology Physician
  • Rome, GA
National Provider Identifier
1104905074
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
049771 Issued in GA
Practice address
315 W 10TH St NE Ste 110
Rome, GA 30165-2676
Phone
(706) 378-7661
Fax
(888) 975-2420
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 049771 GA Primary

Addresses

Primary practice location

315 W 10TH St NE Ste 110
Rome, GA 30165-2676

Mailing address

315 W 10TH St NE Ste 110
Rome, GA 30165-2676
Phone (706) 378-7661

Other identifiers 2

IdentifierTypeStateIssuer
1932311123MedicaidGA
000901766EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901000099 GA Practitioner - Internal MedicinePractitioner - Nephrology 7719952084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

315 W 10TH St NE
Suite 110
Rome, GA 30165-2676
Phone (706) 378-7661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Georgia Nephrology Associates PC Nephrology CurrentSince Feb 12, 2004 Accepting new patients
Atlanta South Nephrology,PC PastSince Oct 27, 2019 Accepting new patients

Locations

315 W 10th St NE
Ste 110
Rome, GA 30165
Phone (706) 378-7661

20 Riverbend Dr SW
Rome, GA 30161
Phone (706) 238-5465

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1104905074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W 10TH ST NE STE 110",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652676",
            "telephone_number": "706-378-7661",
            "fax_number": "706-378-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 10TH ST NE STE 110",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652676",
            "telephone_number": "706-378-7661",
            "fax_number": "888-975-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIMEH",
        "first_name": "HAMID",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "049771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932311123",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000901766E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.