NPIMap

Organization Active NPI

Nephron Corporation

Doing business as Walton Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Monroe, GA
National Provider Identifier
1104930023
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
NEPHRON CORPORATION
Doing business as
Walton Dialysis Center
Practice address
710 Breedlove Dr
Monroe, GA 30655-2054
Phone
(770) 962-1231
Fax
(770) 513-2107
NPI assigned
Aug 18, 2006
Last updated
Mar 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2009

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

Authorized official

Name
Dr. Kirti K Shah, M.D.NPI 1700881612
Title
Medical Director
Phone
(770) 962-1231

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

710 Breedlove Dr
Monroe, GA 30655-2054

Mailing address

605 Old Norcross Rd
Lawrenceville, GA 30045-4315
Phone (770) 962-1231

Other identifiers 2

IdentifierTypeStateIssuer
000576386AMedicaidGA
000576386BMedicaidGA

Other names 1

  • Walton Dialysis Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080922000453 GA Part A Provider - End-Stage Renal Disease Facility (ESRD) 0749241214 Practice locations: Monroe, GA

Other NPIs with the same Medicare PAC ID 7

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

  • Nephron Corporation

    dba Gwinnett Dialysis Center

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Lawrenceville, GA
    • NPI 1285654236

    0749241214

    Same PAC ID
  • Nephron Corporation

    dba Sugar Hill Dialysis Center

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Sugar Hill, GA
    • NPI 1386087989

    0749241214

    Same PAC ID
  • Nephron Corporation

    dba Snellville Dialysis Center

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Snellville, GA
    • NPI 1609007772

    0749241214

    Same PAC ID
  • Nephron Corporation

    dba Dialysis Center of Athens

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Athens, GA
    • NPI 1619441524

    0749241214

    Same PAC ID
  • Nephron Corporation

    dba Barrow County Dialysis Center

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Winder, GA
    • NPI 1922029917

    0749241214

    Same PAC ID
  • Nephron Corporation

    dba Nephron -Norcross Dialysis Center

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Norcross, GA
    • NPI 1952613093

    0749241214

    Same PAC ID
  • Nephron Corporation

    dba Duluth Dialysis Center

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Duluth, GA
    • NPI 1962658807

    0749241214

    Same PAC ID

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Walton Dialysis CenterCCN 112804
Ownership
Non-profit
Certified
Dec 15, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Other
Dialysis stations
21

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
11D0891636Walton Dialysis Center710 Breedlove Drive, Monroe, GA 30655Certificate of waiverSep 12, 2026

National Provider Directory

National Provider Directory
Tax ID family
Nephron Corporation8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236556800000",
    "number": "1104930023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300454315",
            "telephone_number": "770-962-1231",
            "fax_number": "770-513-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 BREEDLOVE DR",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306552054",
            "telephone_number": "770-962-1231",
            "fax_number": "770-513-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHRON CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2009-03-09",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KIRTI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-962-1231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "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": "000576386A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000576386B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walton Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; 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.