Individual provider Active NPI

Andre D Feria, MD

  • Nephrology Physician
  • Lagrange, GA
National Provider Identifier
1205828134
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
048513 Issued in GA
Practice address
142 Old Mill Road
Lagrange, GA 30241-6704
Phone
(706) 885-1900
Fax
(706) 882-1350
NPI assigned
Aug 17, 2005
Last updated
Jun 30, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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 048513 GA Primary

Addresses

Primary practice location

142 Old Mill Road
Lagrange, GA 30241-6704

Mailing address

142 Old Mill Road
Lagrange, GA 30241-6704
Phone (706) 885-1900

Other identifiers 1

IdentifierTypeStateIssuer
000866203AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041129000428 GA Practitioner - Internal MedicinePractitioner - HospitalistPractitioner - Nephrology 4284699562 Reassigns benefits to 2 organizations
I20080513000090 AL Practitioner - Internal MedicinePractitioner - Nephrology 4284699562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

142 Old Mill Rd
Lagrange, GA 30241-6704

4459 Hwy 431
Roanoke, AL 36274-2603
Phone (334) 863-8365

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048513GAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Andre D. Feria MD PC Nephrology CurrentSince Apr 1, 2000 Accepting new patients
The Emory Clinic Inc Nephrology CurrentSince Apr 1, 2012 Accepting new patients
West Georgia Medical Group-Lagrange CurrentSince Aug 24, 2009 Accepting new patients
Talladega Nephrology, LLC Nephrology CurrentSince Dec 15, 2006 Accepting new patients
Dialysis Care Center Newnan Home LLC PastSince Oct 31, 2023 Accepting new patients

Locations

4459 Highway 431
Roanoke, AL 36274
Phone (334) 863-8365

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

142 Old Mill Rd
Lagrange, GA 30241
Phone (706) 882-7440

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHFAD/Endpoint/IBHFAD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1205828134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 OLD MILL ROAD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302416704",
            "telephone_number": "706-885-1900",
            "fax_number": "706-882-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 OLD MILL ROAD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302416704",
            "telephone_number": "706-885-1900",
            "fax_number": "706-882-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERIA",
        "first_name": "ANDRE",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "048513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000866203A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.