Sugarloaf Dialysis LLC

Primary specialty

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

License

ESRD001255 Issued in GA

Legal business name

SUGARLOAF DIALYSIS LLC

Practice address

1705 Belle Meade CT Ste 110
Lawrenceville, GA 30043-5895

Phone

(770) 513-2833

Fax

(770) 513-7611

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Samuel T Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sugarloaf Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

DaVita Sugarloaf DialysisCCN 112758

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 19, 2005

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

20

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

CLIA laboratory certificates

Member of 2

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

• Nephrology Medical Associates of Georgia LLC

  • Nephrology Physician
  • Thomasville, GA
  • NPI 1740706951

  Member Of

  NPD member
• Renal Treatment Centers Mid Atlantic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Goldsboro, NC
  • NPI 1174086698

  Member Of

  NPD member

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Kimathi Sipho Ricardo Blackwood, M.D.

  • Nephrology Physician
  • Macon, GA
  • NPI 1609071448

  Dialysis facility

  Care Compare affiliation Name & address match
• Divakar Jammalamadaka, MD

  • Nephrology Physician
  • Snellville, GA
  • NPI 1265699920

  Dialysis facility

  Care Compare affiliation Name & address match
• Jayanti Jasti, M.D.,

  • Nephrology Physician
  • Lawrenceville, GA
  • NPI 1487619045

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784246400000",
    "number": "1669426813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 BELLE MEADE CT STE 110",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435895",
            "telephone_number": "770-513-2833",
            "fax_number": "770-513-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGARLOAF DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "GA",
            "license": "ESRD001255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000973J34K",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sugarloaf Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sugarloaf Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Anne Sturgis
• Jordan Matthew Suarez, PT
• Nehemiah Joseph Suarez
• Suburban Hematology Oncology Associates, PC
• Sugarloaf Crossing Dental Center LLC
• Sugarloaf Family Chiropractic, LLC
• Sugarloaf Hearing Aid Factory Outlet
• Sugarloaf Pediatrics, PC
• Sugarloaf Pharmacy Inc
• Sugarloaf Pkwy Pharmacy Inc.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Lawrenceville, GA
• Providers in Lawrenceville, 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 17, 2026; 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.