NPIMap

Individual provider Active NPI

Courage A Atekha, M.D.

  • Nephrology Physician
  • Statesboro, GA
National Provider Identifier
1124119219
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
049266 Issued in GA
Practice address
1030 Bermuda Run
Statesboro, GA 30458-0858
Phone
(912) 764-8396
Fax
(912) 764-7188
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 049266 GA Primary
Renal Dialysis Technician 2472R0900X 049266 GA

Addresses

Primary practice location

1030 Bermuda Run
Statesboro, GA 30458-0858

Mailing address

1030 Bermuda Run
Statesboro, GA 30458-0858
Phone (912) 764-8396

Other identifiers 1

IdentifierTypeStateIssuer
000933413K,L,M,N,O,PMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050621000801 GA Practitioner - Nephrology 5991740011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1030 Bermuda Run
Statesboro, GA 30458-0858
Phone (912) 764-8396

Hospital & facility affiliations

  • DaVita East Georgia Dialysis Dialysis facility, Statesboro, GA, CCN 112710
  • DaVita Vidalia First Street Dialysis Dialysis facility, Vidalia, GA, CCN 112723
  • DaVita Candler County Dialysis Dialysis facility, Metter, GA, CCN 112624
  • Fresenius Medical Care of Bulloch County Dialysis facility, Statesboro, GA, CCN 112766
  • East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075
  • Memorial Health Meadows Hospital Hospital, Vidalia, GA, CCN 110128
  • Candler County Hospital Hospital, Metter, GA, CCN 111334
  • Evans Memorial Hospital Hospital, Claxton, GA, CCN 110142
  • Emanuel Medical Center Hospital, Swainsboro, GA, CCN 110109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000859NYMDPsychoanalyst
049266GAMDRenal Dialysis Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Lincon Medical and Mental Center Past Accepting new patients
Nephrology Medical Associates of Georgia LLC Nephrology Past Accepting new patients
Downtown Bronx Medical Associates PC Past Accepting new patients
Total Renal Care Inc PastSince Oct 22, 2007 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: courage.atekha@direct.davitaphysiciansolutions.com

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1124119219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 BERMUDA RUN",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580858",
            "telephone_number": "912-764-8396",
            "fax_number": "912-764-7188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 BERMUDA RUN",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580858",
            "telephone_number": "912-764-8396",
            "fax_number": "912-764-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATEKHA",
        "first_name": "COURAGE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "049266",
            "primary": true
        },
        {
            "code": "2472R0900X",
            "taxonomy_group": "",
            "desc": "Technician, Other, Renal Dialysis",
            "state": "GA",
            "license": "049266",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000933413K,L,M,N,O,P",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.