Kidney Nutrition Specialist LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

KIDNEY NUTRITION SPECIALIST LLC

Practice address

1425 Highway 34 E
Newnan, GA 30265-1323

Phone

(470) 205-0119

Fax

(770) 580-1880

NPI assigned

Jun 29, 2020

Last updated

Jul 8, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jadeda Darwashia Hooks, RDNNPI 1174834493

Title

President

Phone

(770) 568-0162

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Nephrology Inc

  dba Kidney Clinic

  • Nephrology Physician
  • Newnan, GA
  • NPI 1083803472

  O20200804001543

  Same enrollment

Tax ID family

Kidney Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nephrology Inc

  dba Kidney Clinic

  • Nephrology Physician
  • Newnan, GA
  • NPI 1083803472
  NPD tax ID

Locations

Practitioners 1

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.

• Jadeda Hooks, RDN, CSR

  • Registered Dietitian
  • Newnan, GA
  • NPI 1174834493

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1316564909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 HIGHLAND HILLS RD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302145429",
            "telephone_number": "770-568-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 HIGHWAY 34 E",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651323",
            "telephone_number": "470-205-0119",
            "fax_number": "770-580-1880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 Highland Hills Rd",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302145429",
            "country_code": "US",
            "telephone_number": "470-205-0119",
            "fax_number": "770-580-1880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Governors Sq Ste C",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302694862",
            "country_code": "US",
            "telephone_number": "470-205-0119",
            "fax_number": "770-580-1880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIDNEY NUTRITION SPECIALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-29",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "HOOKS",
        "authorized_official_first_name": "JADEDA",
        "authorized_official_middle_name": "DARWASHIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-568-0162",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shazia Khan, MD
• Syeda Maimuna Ali Khan, M.D.
• Geeta Bai Khanwani, MD
• Michael Nabil Khoury, M.D.
• Amanda Kidder
• Kidzone Urgent Care, Inc. (Kidzone Urgent Care)
• Corrie Kief
• Beomjune B Kim, DMD, MD, FACS
• Jihye Kim, MD
• Min Hui Kim, M.D.

• Registered Dietitian in Newnan, GA
• Providers in Newnan, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.