NPIMap

Organization Active NPI

Andre D. Feria MD PC

  • Nephrology Physician
  • Lagrange, GA
National Provider Identifier
1386780104
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
048513 Issued in GA
Legal business name
ANDRE D. FERIA MD PC
Practice address
142 Old Mill Road
Lagrange, GA 30241
Phone
(706) 885-1900
Fax
(706) 882-1350
NPI assigned
Jan 29, 2007
Last updated
Jan 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Authorized official

Name
Dr. Andre D. Feria, MDNPI 1205828134
Title
President
Phone
(706) 885-1900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 048513 GA Primary

Addresses

Primary practice location

142 Old Mill Road
Lagrange, GA 30241

Mailing address

142 Old Mill Road
Lagrange, GA 30241
Phone (706) 885-1900

Other practice location 1

106 W 4th Ave
Cordele, GA 31015-3214
Phone (229) 271-3200

Other names 1

  • The Kidney Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050124000837 AL Part B Supplier - Clinic/Group Practice 3577513977 Receives reassigned benefits from 1 practitioner
Practice locations: Roanoke, AL
O20070323000055 GA Part B Supplier - Clinic/Group Practice 3577513977 Receives reassigned benefits from 9 practitioners
Practice locations: Lagrange, GA; Cordele, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2174010Andre D Feria, MD, PC142 Old Mill Road, Lagrange, GA 30241Certificate of waiverOct 22, 2027
11D2274187Andre D Feria, MD, PC106 West 4TH Avenue, Cordele, GA 31015Certificate of waiverDec 27, 2026

National Provider Directory

National Provider Directory

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1386780104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 OLD MILL ROAD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30241",
            "telephone_number": "706-885-1900",
            "fax_number": "706-882-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 OLD MILL ROAD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30241",
            "telephone_number": "706-885-1900",
            "fax_number": "706-882-1350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 W 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Cordele",
            "state": "GA",
            "postal_code": "310153214",
            "country_code": "US",
            "telephone_number": "229-271-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANDRE D. FERIA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "FERIA",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-885-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "048513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Kidney Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Kidney Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.

Verify at the official NPI Registry.