Individual provider Active NPI

Clara W Truesdell, MD

  • Nephrology Physician
  • Suwanee, GA
National Provider Identifier
1508854811
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
034974 Issued in GA
Practice address
185 Old Peachtree Rd NW
Suwanee, GA 30024-2511
Phone
(678) 937-0300
Fax
(781) 464-2599
NPI assigned
Oct 11, 2005
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 034974 GA Primary

Addresses

Primary practice location

185 Old Peachtree Rd NW
Suwanee, GA 30024-2511

Mailing address

185 Old Peachtree Rd NW
Suwanee, GA 30024-2511
Phone (678) 937-0300

Other practice location 1

5723 Memorial Dr
Stone Mountain, GA 30083-3425
Phone (678) 937-0300

Other identifiers 2

IdentifierTypeStateIssuer
000641253JMedicaidGA
000641253 F TO IMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ctruesdell31760@direct.acumenmd.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110914000120 GA Practitioner - Nephrology 9537160189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Emory University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hypertension and Kidney Consultants of Georgia PCGroup PAC ID 0345238077, 2 clinicians

Practice addresses (Care Compare)

185 Old Peachtree Rd NW
Suwanee, GA 30024-2511
Phone (678) 937-0300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
034974GAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hypertension & Kidney Consultants of Georgia PC Nephrology CurrentSince Jan 1, 2011 Accepting new patients
Stone Mountain Dialysis Center, LLC PastSince Aug 28, 2021 Accepting new patients
Norcross Dialysis Center, LLC PastSince May 1, 2008 Accepting new patients

Locations

5723 Memorial Dr
Stone Mountain, GA 30083
Phone (678) 836-0251

185 Old Peachtree Rd NW
Suwanee, GA 30024
Phone (678) 714-4941

Organizations & group practices 3

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

Hospital & facility affiliations 5

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1508854811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 OLD PEACHTREE RD NW",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242511",
            "telephone_number": "678-937-0300",
            "fax_number": "781-464-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 OLD PEACHTREE RD NW",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242511",
            "telephone_number": "678-937-0300",
            "fax_number": "781-464-2599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5723 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Stone Mountain",
            "state": "GA",
            "postal_code": "300833425",
            "country_code": "US",
            "telephone_number": "678-937-0300",
            "fax_number": "781-464-2599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUESDELL",
        "first_name": "CLARA",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "034974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000641253J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000641253 F TO I",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctruesdell31760@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "185 Old Peachtree Rd NW",
            "city": "Suwanee",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300242511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.