Active NPI
Pruitthealth Dialysis Services, Inc.
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Augusta, GA
National Provider Identifier
1245047091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- PRUITTHEALTH DIALYSIS SERVICES, INC.
- Practice address
- 2021 Scott Rd Ste 500
Augusta, GA 30906-2539 - Phone
- (770) 279-6200
- NPI assigned
- Dec 16, 2024
- 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
- Mr. Neil L Pruitt Jr.
- Title
- Chairman and Ceo
- Phone
- (770) 279-6200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
2021 Scott Rd Ste 500
Augusta, GA 30906-2539
Mailing address
1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (770) 279-6200
National Provider Directory
National Provider DirectoryLocations
2021 Scott Rd
Ste 500
Augusta, GA 30906
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734307200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1734307200000",
"number": "1245047091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1626 JEURGENS CT",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300932219",
"telephone_number": "770-279-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2021 SCOTT RD STE 500",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309062539",
"telephone_number": "770-279-6200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRUITTHEALTH DIALYSIS SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2024-12-16",
"last_updated": "2024-12-16",
"certification_date": "2024-12-16",
"status": "A",
"authorized_official_last_name": "PRUITT",
"authorized_official_first_name": "NEIL",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CHAIRMAN AND CEO",
"authorized_official_telephone_number": "770-279-6200",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.