Organization Active NPI

North Atlanta Nephrology LLC

  • Nephrology Physician
  • Canton, GA
National Provider Identifier
1154411437
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
053602 Issued in GA
Legal business name
NORTH ATLANTA NEPHROLOGY LLC
Practice address
219 Riverstone Dr
Canton, GA 30114-5256
Phone
(770) 720-2423
Fax
(877) 430-2887
NPI assigned
Oct 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Authorized official

Name
Najam Sabreen, M.D.NPI 1699701995
Title
M.D.
Phone
(770) 720-2423

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 053602 GA Primary

Addresses

Primary practice location

219 Riverstone Dr
Canton, GA 30114-5256

Mailing address

PO Box 2815
Blue Ridge, GA 30513-0050
Phone (770) 720-2423

Other identifiers 1

IdentifierTypeStateIssuer
052767088AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429001232 GA Part B Supplier - Clinic/Group Practice 0840287868 Receives reassigned benefits from 1 practitioner
Practice locations: Canton, GA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

145 Riverstone Ter
Ste 100
Canton, GA 30114
Phone (770) 704-9499

14 Sammy McGhee Blvd
Ste 203
Jasper, GA 30143
Phone (678) 456-8782

620 J L White Dr
Ste 140
Jasper, GA 30143
Phone (706) 253-3500

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582588800000",
    "number": "1154411437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2815",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305130050",
            "telephone_number": "770-720-2423",
            "fax_number": "877-430-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 RIVERSTONE DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145256",
            "telephone_number": "770-720-2423",
            "fax_number": "877-430-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ATLANTA NEPHROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-15",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A",
        "authorized_official_last_name": "SABREEN",
        "authorized_official_first_name": "NAJAM",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "770-720-2423",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "053602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052767088A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.