NPIMap

Organization Active NPI

Fresenius Medical Care Northeast Atlanta, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dacula, GA
National Provider Identifier
1659910974
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
FRESENIUS MEDICAL CARE NORTHEAST ATLANTA, LLC
Practice address
3441 Fence Rd
Dacula, GA 30019-1219
Phone
(770) 277-7313
Fax
(770) 277-7344
NPI assigned
Jan 3, 2020
Organization subpart
Yes
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Authorized official

Name
James Joseph Divito
Title
Vice President
Phone
(781) 699-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

3441 Fence Rd
Dacula, GA 30019-1219

Mailing address

3441 Fence Rd
Dacula, GA 30019-1219
Phone (770) 277-7313

Other names 1

  • Fresenius Kidney Care Dacula Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578009600000",
    "number": "1659910974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 FENCE RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191219",
            "telephone_number": "770-277-7313",
            "fax_number": "770-277-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3441 FENCE RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191219",
            "telephone_number": "770-277-7313",
            "fax_number": "770-277-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE NORTHEAST ATLANTA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "DIVITO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresenius Kidney Care Dacula",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.