Renviva Dialysis Center of North Georgia LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

RENVIVA DIALYSIS CENTER OF NORTH GEORGIA LLC

Practice address

6120 Windward Pkwy Ste 170
Alpharetta, GA 30005-4185

Phone

(321) 710-0352

NPI assigned

Feb 1, 2024

Last updated

Feb 1, 2024By 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

Akinyinka Awosika

Title

Member Manager

Phone

(321) 710-0352

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1356104418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 WINDWARD PKWY STE 170",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 WINDWARD PKWY STE 170",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054185",
            "telephone_number": "321-710-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENVIVA DIALYSIS CENTER OF NORTH GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "AWOSIKA",
        "authorized_official_first_name": "AKINYINKA",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "321-710-0352"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reliant Senior Living LLC (Living Rehab)
• Latoya N Rembert, OWNER
• Neal David Render
• Renew Healthcare, LLC
• Fernando Rengifo-Caicedo, SLP007041
• Rep Perimeter Holdings, LLC (Perimeter Healthcare)
• Respond Resource Inc
• Resurgens, LLC (Georgia Physical Therapy & Rehab)
• Resurgens, LLC (nMotion)
• Revive Counseling Center LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.