NPIMap

Organization Active NPI

Nephrology & Hypertension Medical Associates, PC

  • Nephrology Physician
  • Jesup, GA
National Provider Identifier
1437229309
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
026402 Issued in GA
Legal business name
NEPHROLOGY & HYPERTENSION MEDICAL ASSOCIATES, PC
Practice address
111 Colonial Way Ste 2
Jesup, GA 31545-0132
Phone
(912) 588-1919
Fax
(912) 354-7569
NPI assigned
Nov 8, 2006
Last updated
May 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Authorized official

Name
Trish G Rotureau
Title
Operation Manager
Phone
(912) 650-5450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 026402 GA Primary

Addresses

Primary practice location

111 Colonial Way Ste 2
Jesup, GA 31545-0132

Mailing address

208 Scranton Connector
Suite 117
Brunswick, GA 31525-0559
Phone (912) 264-5961

Other identifiers 9

IdentifierTypeStateIssuer
000291079AMedicaidGA
000291079QMedicaidGA
000291079MMedicaidGA
000291079OMedicaidGA
630423104AMedicaidGA
630423104CMedicaidGA
000291079KMedicaidGA
000291079ZMedicaidGA
GRP2930OtherGAMEDICARE GROUP

Other names 1

  • Nephrology and Endocrinolgy Consultants Other name

National Provider Directory

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": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1437229309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SCRANTON CONNECTOR",
            "address_2": "SUITE 117",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250559",
            "telephone_number": "912-264-5961",
            "fax_number": "912-262-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLONIAL WAY STE 2",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450132",
            "telephone_number": "912-588-1919",
            "fax_number": "912-354-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY & HYPERTENSION MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "ROTUREAU",
        "authorized_official_first_name": "TRISH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OPERATION MANAGER",
        "authorized_official_telephone_number": "912-650-5450"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "026402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000291079A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000291079Q",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000291079M",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000291079O",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630423104A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630423104C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000291079K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000291079Z",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "GRP2930",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nephrology and Endocrinolgy Consultants",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Nephrology and Endocrinolgy Consultants",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.