Organization Active NPI

Ahmed Elsharkawi MD LLC

  • Nephrology Physician
  • Brunswick, GA
National Provider Identifier
1184856494
Registry record updated Aug 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
55128 Issued in GA
Legal business name
AHMED ELSHARKAWI MD LLC
Practice address
390 Eh CT
Brunswick, GA 31520-2198
Phone
(912) 267-4900
Fax
(912) 267-4960
NPI assigned
Aug 20, 2009
Last updated
Aug 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2009

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

Authorized official

Name
Ahmed Elsharkawi, MDNPI 1861456378
Title
Ceo
Phone
(912) 267-4900

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 Physician 207RN0300X 55128 GA Primary

Addresses

Primary practice location

390 Eh CT
Brunswick, GA 31520-2198

Mailing address

390 Eh CT
Brunswick, GA 31520-2198
Phone (912) 267-4900

Other identifiers 1

IdentifierTypeStateIssuer
663552717AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091021000802 GA Part B Supplier - Clinic/Group Practice 4385781467 Receives reassigned benefits from 9 practitioners
Practice locations: Saint Mary S, GA; Waycross, GA; Jesup, GA; Hinesville, GA; Folkston, GA; Brunswick, GA; Baxley, GA

National Provider Directory

National Provider Directory

Locations

195 E Tollison St
Baxley, GA 31513
Phone (912) 366-6008

195 E Tollison St
Ste C
Baxley, GA 31513

3025 Shrine Rd
Ste 270
Brunswick, GA 31520
Phone (912) 262-2723

3150 Glynn Ave
Brunswick, GA 31520
Phone (912) 261-4997

53 Scranton Connector
Brunswick, GA 31525
Phone (912) 264-8657

330 Peachtree St
Jesup, GA 31545
Phone (912) 415-8552

130 N Gross Rd
Ste 203
Kingsland, GA 31548
Phone (912) 262-6691

2040 Dan Proctor Dr
Ste 200
Saint Marys, GA 31558
Phone (912) 576-6376

308 Carswell Ave
Waycross, GA 31501
Phone (912) 285-1663

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1184856494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 EH CT",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315202198",
            "telephone_number": "912-267-4900",
            "fax_number": "912-267-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 EH CT",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315202198",
            "telephone_number": "912-267-4900",
            "fax_number": "912-267-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHMED ELSHARKAWI MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "ELSHARKAWI",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-267-4900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "55128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "663552717A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.