Active NPI
Nephrology Medical Associates of Georgia LLC
- Internal Medicine Physician
- Salt Lake City, UT
National Provider Identifier
1679533012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA LLC
- Practice address
- 880 E 3900 S
Ste B
Salt Lake City, UT 84107-2151 - Phone
- (801) 268-1296
- Fax
- (801) 268-0340
- NPI assigned
- Mar 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Gary William Bell
- Title
- Vice President & Controller
- Phone
- (800) 310-4872
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary | ||
| Nephrology Physician | 207RN0300X |
Addresses
Primary practice location
880 E 3900 S
Ste B
Salt Lake City, UT 84107-2151
Mailing address
PO Box 2355
Tacoma, WA 98401
Phone (800) 310-4872
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W0522 | Medicaid | UT |
Other names 1
- DaVita Nephrology Partners
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Burlington, WA
- NPI 1932595584
Member Of
Locations
880 E 3900 S
Ste B
Salt Lake City, UT 84107
Phone (801) 268-1296
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1679533012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2355",
"city": "TACOMA",
"state": "WA",
"postal_code": "98401",
"telephone_number": "800-310-4872",
"fax_number": "877-328-4923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "880 E 3900 S",
"address_2": "STE B",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841072151",
"telephone_number": "801-268-1296",
"fax_number": "801-268-0340"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-27",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "BELL",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "WILLIAM",
"authorized_official_title_or_position": "VICE PRESIDENT & CONTROLLER",
"authorized_official_telephone_number": "800-310-4872",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RN0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "W0522",
"state": "UT"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "DaVita Nephrology Partners",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.