Organization Active NPI

Nephrology Group Consultants

  • Nephrology Physician
  • Douglas, GA
National Provider Identifier
1407588205
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHROLOGY GROUP CONSULTANTS
Practice address
2012 Ocilla Rd
Douglas, GA 31533-2230
Phone
(912) 384-7210
Fax
(912) 384-5130
NPI assigned
Jun 29, 2022
Last updated
Jan 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Authorized official

Name
Thet N Zaw, MDNPI 1750690277
Title
Ceo
Phone
(912) 209-4600

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary
Medical Specialty Clinic/Center 261QM2500X NU

Addresses

Primary practice location

2012 Ocilla Rd
Douglas, GA 31533-2230

Mailing address

1001 Ward St W
Douglas, GA 31533-2263

Other practice location 1

624 Love Ave
Tifton, GA 31794-4406
Phone (912) 384-7210

Other practice location 2

194 Perry House Road, Suite A,
Fitzgerald, GA 31750
Phone (912) 384-7210

Other practice location 3

101 W Northside Dr Bldg E
Valdosta, GA 31602-1752
Phone (912) 384-7210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221117000859 GA Part B Supplier - Clinic/Group Practice 0547638843 Receives reassigned benefits from 4 practitioners
Practice locations: Valdosta, GA; Tifton, GA; Fitzgerald, GA; Douglas, GA

National Provider Directory

National Provider Directory

Locations

190 Westside Dr
Ste A
Douglas, GA 31533
Phone (912) 384-3439

101 W Northside Dr
Bldg E
Valdosta, GA 31602
Phone (912) 384-7210

Practitioners & affiliated clinicians

Practitioners 4

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": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1407588205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 WARD ST W",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 OCILLA RD",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332230",
            "telephone_number": "912-384-7210",
            "fax_number": "912-384-5130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 Love Ave",
            "address_purpose": "LOCATION",
            "city": "Tifton",
            "state": "GA",
            "postal_code": "317944406",
            "country_code": "US",
            "telephone_number": "912-384-7210",
            "fax_number": "912-384-5130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "194 Perry House Road, Suite A,",
            "address_purpose": "LOCATION",
            "city": "Fitzgerald",
            "state": "GA",
            "postal_code": "31750",
            "country_code": "US",
            "telephone_number": "912-384-7210",
            "fax_number": "912-384-5130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 W Northside Dr Bldg E",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316021752",
            "country_code": "US",
            "telephone_number": "912-384-7210",
            "fax_number": "912-384-5130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEPHROLOGY GROUP CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-29",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "ZAW",
        "authorized_official_first_name": "THET",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-209-4600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.