Organization Active NPI

Nephrology Medical Associates of Georgia LLC

  • Internal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1679533012
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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

Updated by the provider on Sep 11, 2025

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
W0522MedicaidUT

Other names 1

  • DaVita Nephrology Partners Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

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.

Verify at the official NPI Registry.