Active NPI
Emory Dialysis, LLC
Doing business as Emory Dialysis at North Decatur
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Decatur, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- EMORY DIALYSIS, LLC
- Doing business as
- Emory Dialysis at North Decatur
- Practice address
- 2165 N Decatur Rd
Decatur, GA 30033-5307 - Phone
- (404) 251-2330
- Fax
- (404) 251-2331
- NPI assigned
- Aug 1, 2017
- Last updated
- Feb 9, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Kimberly Agee-Clark Johnson, MBA
- Title
- Credentialing Coord.
- Phone
- (229) 387-3528
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | NU | Primary |
Addresses
Primary practice location
2165 N Decatur Rd
Decatur, GA 30033-5307
Mailing address
PO Box 7710
Tifton, GA 31793-7710
Phone (229) 387-3528
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003205167A | Medicaid | GA |
Other names 1
- Emory Dialysis at North Decatur
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180118000970 | GA | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 9931249364 | Practice locations: Decatur, GA |
Other NPIs with the same Medicare PAC ID 4
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Emory Dialysis at Northside
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Atlanta, GA
- NPI 1013142843
9931249364
-
dba Emory Dialysis at Greenbriar
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- East Point, GA
- NPI 1316180649
9931249364
-
dba Emory Dialysis Saint Joseph's
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Atlanta, GA
- NPI 1477985992
9931249364
-
dba Emory Dialysis at Candler
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Decatur, GA
- NPI 1972746204
9931249364
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- Emory Dialysis at North Decatur
- Overall star rating
- Ownership
- Non-profit
- Certified
- Apr 17, 2018
- Medicare certification status
- Active
- Dialysis stations
- 22
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2138805 | Emory Dialysis at North Decatur | Certificate of waiver | Oct 24, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Emory Dialysis
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Emory Dialysis at Northside
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Atlanta, GA
- NPI 1013142843
-
dba Emory Dialysis at Greenbriar
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- East Point, GA
- NPI 1316180649
-
dba Emory Dialysis Saint Joseph's
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Atlanta, GA
- NPI 1477985992
-
dba Emory Dialysis at Candler
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Decatur, GA
- NPI 1972746204
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba The Emory Clinic LaGrange Surgery Center
- Ambulatory Surgical Clinic/Center
- Lagrange, GA
- NPI 1285912600
Member Of
Locations
1000 Centre Pkwy
Ste 180
East Point, GA 30344
Phone (404) 778-1001
5673 Peachtree Dunwoody Rd
Ste 501
Sandy Springs, GA 30342
Phone (404) 778-8075
Practitioners & affiliated clinicians
Affiliated clinicians 8
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501545600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1770595200000",
"number": "1225552391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7710",
"city": "TIFTON",
"state": "GA",
"postal_code": "317937710",
"telephone_number": "229-387-3528",
"fax_number": "229-386-2149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2165 N DECATUR RD",
"city": "DECATUR",
"state": "GA",
"postal_code": "300335307",
"telephone_number": "404-251-2330",
"fax_number": "404-251-2331"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMORY DIALYSIS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-08-01",
"last_updated": "2026-02-09",
"certification_date": "2026-02-09",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "KIMBERLY",
"authorized_official_middle_name": "AGEE-CLARK",
"authorized_official_title_or_position": "CREDENTIALING COORD.",
"authorized_official_telephone_number": "229-387-3528",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "MBA"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003205167A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Emory Dialysis at North Decatur",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; 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.