NPIMap

Organization Active NPI

Renal Associates, LLC

  • Nephrology Physician
  • Columbus, GA
National Provider Identifier
1205944311
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
038662,049226,053587 Issued in GA
Legal business name
RENAL ASSOCIATES, LLC
Practice address
6228 Bradley Park Dr
Suite a
Columbus, GA 31904-3603
Phone
(706) 322-1486
Fax
(706) 324-3419
NPI assigned
Aug 28, 2006
Last updated
Dec 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Authorized official

Name
Mrs. Beverly Reynolds
Title
Office Manager
Phone
(706) 322-1486

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 038662,049226,053587 GA Primary

Addresses

Primary practice location

6228 Bradley Park Dr
Suite a
Columbus, GA 31904-3603

Mailing address

6228 Bradley Park Dr
Suite a
Columbus, GA 31904-3603
Phone (706) 322-1486

Other identifiers 2

IdentifierTypeStateIssuer
55003365AMedicaidGA
CI3630OtherGARAILROAD MEDICARE GROUP #

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040216000095 GA Part B Supplier - Clinic/Group Practice 7911891403 Receives reassigned benefits from 14 practitioners
Practice locations: Columbus, GA; Americus, GA
O20051110000977 AL Part B Supplier - Clinic/Group Practice 7911891403 Receives reassigned benefits from 15 practitioners
Practice locations: Eufaula, AL; Phenix City, AL; Opelika, AL

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
11D0266598Renal Associates LLC6228 Bradley Park Dr Suite a, Columbus, GA 31904Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

2340 Pepperell Pkwy
Ste A
Opelika, AL 36801

1432 E Forsyth St
Americus, GA 31709
Phone (229) 924-9709

1300 Lafayette Pkwy
Ste D
Lagrange, GA 30241
Phone (706) 882-2800

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1205944311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6228 BRADLEY PARK DR",
            "address_2": "SUITE A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319043603",
            "telephone_number": "706-322-1486",
            "fax_number": "706-324-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6228 BRADLEY PARK DR",
            "address_2": "SUITE A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319043603",
            "telephone_number": "706-322-1486",
            "fax_number": "706-324-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-322-1486",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "038662,049226,053587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55003365A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CI3630",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.