Nra-Milledgeville Georgia LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

ESRD001231 Issued in GA

Legal business name

NRA-MILLEDGEVILLE GEORGIA LLC

Doing business as

Oconee Dialysis Center

Practice address

421 N Jefferson St NE
Milledgeville, GA 31061-2920

Phone

(478) 451-0064

Fax

(478) 453-8043

NPI assigned

May 26, 2006

Last updated

Jul 22, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jon M. Sundock

Title

Vice President

Phone

(615) 507-3307

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Oconee Dialysis Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• National Medical Care, Inc.

  dba RCC Sebring

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Sebring, FL
  • NPI 1477665214

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437523200000",
    "number": "1598711871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 W. MCEWEN DRIVE",
            "address_2": "SUITE 500",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370671731",
            "telephone_number": "615-661-1100",
            "fax_number": "615-507-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N JEFFERSON ST NE",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612920",
            "telephone_number": "478-451-0064",
            "fax_number": "478-453-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NRA-MILLEDGEVILLE GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-07-22",
        "status": "A",
        "authorized_official_last_name": "SUNDOCK",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-507-3307",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "GA",
            "license": "ESRD001231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERTIFICATE OF WAIVE",
            "identifier": "11D1049749",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230307270A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oconee Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diane Nobles, NURSE PRACTITIONER
• Alice G. Noel, L.C.S.W.,D.C.S.W.
• Hannah Snow Nolan
• Nourish Mind and Body LLC
• Novo Ignis Tabellarium Logistics LLC
• NSH Cancer Institute Professional Services G LLC
• Ashley O'Gorman
• Adrienne Oakman, LMSW
• Oconee Area Hospitalist, LLC
• Oconee Center

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; 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.