Southside Kidney Clinics, PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

SOUTHSIDE KIDNEY CLINICS, PC

Practice address

3580 Cameron Parkway
Stockbridge, GA 30281

Phone

(770) 996-6446

Fax

(770) 996-6279

NPI assigned

Jul 16, 2006

Last updated

Jan 14, 2008By 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

Miss Kim A Thorpe

Title

LPN Office Manager

Phone

(770) 996-6446

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCDIAA

Practitioners 5

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.

• Mohamad M Kassem, M.D.

  • Nephrology Physician
  • Stockbridge, GA
  • NPI 1891726121
  Medicare reassignment Care Compare group NPD
• Fahad Khan, MD

  • Nephrology Physician
  • Stockbridge, GA
  • NPI 1073742029
  Medicare reassignment Care Compare group NPD
• Chadi Obeid, MD

  • Nephrology Physician
  • Stockbridge, GA
  • NPI 1346470226
  Medicare reassignment Care Compare group NPD
• Lawrence Earl Bryant Jr., APRN

  • Adult Health Nurse Practitioner
  • Stockbridge, GA
  • NPI 1831535541
  Medicare reassignment NPD
• Nicole Tamara Johnson, NP

  • Adult Health Nurse Practitioner
  • Stockbridge, GA
  • NPI 1710116769
  Medicare reassignment NPD

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1659398600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 CAMERON PARKWAY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-996-6446",
            "fax_number": "770-996-6279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 CAMERON PARKWAY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-996-6446",
            "fax_number": "770-996-6279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE KIDNEY CLINICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "THORPE",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LPN OFFICE MANAGER",
        "authorized_official_telephone_number": "770-996-6446",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Crescent Women's Health Specialists (women's health specialists)
• Southern Crescent Womens Health Specialists at Eagle's Landing (Women's Health Specialists)
• Southern Medical Clinic LLC
• Southern Medical Clinic, LLC
• Southside Behavioral Health, Inc. (Behavioral Healthcare Solutions, Inc.)
• Southside Medical Center, Inc (Southside Medical Center -Stockbridge)
• Southside Pediatrics
• Southside Psychiatric Associates, P.C.
• Southside Psychiatric Associates, P.C.
• Southside Surgical Assistants, LLC

• Nephrology Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.