NPIMap

Individual provider Active NPI

Shailaja Chidella, M.D

  • Nephrology Physician
  • Lawrenceville, GA
National Provider Identifier
1376786871
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
33362 Issued in AL
Practice address
595 Hurricane Shoals Rd NW Ste 100
Lawrenceville, GA 30046-8762
Phone
(404) 645-7150
NPI assigned
Apr 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 79107 GA
Nephrology Physician 207RN0300X 33362 AL Primary

Addresses

Primary practice location

595 Hurricane Shoals Rd NW Ste 100
Lawrenceville, GA 30046-8762

Mailing address

1649 McFarland Blvd N
Tuscaloosa, AL 35406-2281
Phone (205) 556-5541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141010000944 AL Practitioner - NephrologyPractitioner - Internal Medicine 8224258405 Reassigns benefits to 1 organization
I20181025003151 GA Practitioner - Internal MedicinePractitioner - Neurology 8224258405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Neurology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Georgia Nephrology, LLCGroup PAC ID 4082606496, 29 clinicians

Practice addresses (Care Compare)

6335 Hospital Pkwy
Suite 208
Johns Creek, GA 30097-1551
Phone (404) 645-7150

Hospital & facility affiliations

  • DaVita Snellville Dialysis Dialysis facility, Snellville, GA, CCN 112806
  • DaVita Medlock Bridge Dialysis Dialysis facility, Duluth, GA, CCN 112778
  • DaVita Gainesville Dialysis Dialysis facility, Gainesville, GA, CCN 112693
  • Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
  • Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33362ALMDNephrology Physician
79107GAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tuscaloosa Nephrology Associates PC Nephrology CurrentSince Aug 1, 2014 Accepting new patients

Locations

1850 McFarland Blvd N
Tuscaloosa, AL 35406
Phone (205) 556-5541

Interoperability endpoints

  • Direct secure messaging: schidella12394@direct.acumenmd.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1376786871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1649 MCFARLAND BLVD N",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062281",
            "telephone_number": "205-556-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 HURRICANE SHOALS RD NW STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468762",
            "telephone_number": "404-645-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIDELLA",
        "first_name": "SHAILAJA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "79107",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "33362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.