NPIMap

Individual provider Active NPI

Dwight Alfred McLeish, M.D.

  • Nephrology Physician
  • Thomasville, GA
National Provider Identifier
1669542957
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
047235 Issued in GA
Practice address
415 Bartow St
Thomasville, GA 31792-6076
Phone
(229) 226-6116
Fax
(229) 226-6128
NPI assigned
Nov 8, 2006
Last updated
Jun 27, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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 047235 GA Primary

Addresses

Primary practice location

415 Bartow St
Thomasville, GA 31792-6076

Mailing address

415 Bartow St.
P.O. Box 3027
Thomasville, GA 31799-3027
Phone (229) 226-6116

Other identifiers 1

IdentifierTypeStateIssuer
85002328GMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050331000400 GA Practitioner - Nephrology 2163479304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

415 Bartow St
Thomasville, GA 31799-3027
Phone (229) 226-6116

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
047235GAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Nephrology Center PC CurrentSince Jan 1, 2001 Accepting new patients
Comprehensive Foot and Ankle Center,LLC PastSince Jun 1, 2008 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

415 Bartow St
Thomasville, GA 31792
Phone (229) 226-6116

2704 N Oak St
Bldg H
Valdosta, GA 31602
Phone (229) 247-4151

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 7

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1669542957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BARTOW ST.",
            "address_2": "P.O. BOX 3027",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317993027",
            "telephone_number": "229-226-6116",
            "fax_number": "229-226-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BARTOW ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926076",
            "telephone_number": "229-226-6116",
            "fax_number": "229-226-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEISH",
        "first_name": "DWIGHT",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "047235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85002328G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.