Organization Active NPI

Nephrology Medical Associates of Georgia LLC

Doing business as Nebraska Kidney Care

  • Nephrology Physician
  • Grand Island, NE
National Provider Identifier
1689827370
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA LLC
Doing business as
Nebraska Kidney Care
Practice address
638 N Webb Rd
Suite B
Grand Island, NE 68803-4057
Phone
(308) 382-0121
Fax
(308) 382-0572
NPI assigned
Oct 28, 2008
Last updated
Jan 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Authorized official

Name
Deron Frank
Title
Senior VP
Phone
(310) 536-2402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

638 N Webb Rd
Suite B
Grand Island, NE 68803-4057

Mailing address

2000 16TH St
Denver, CO 80202
Phone (303) 876-7243

Other identifiers 1

IdentifierTypeStateIssuer
10025674900MedicaidNE

Other names 1

  • Nebraska Kidney Care Doing business as

National Provider Directory

National Provider Directory

Member of 2

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

Locations

2000 16th St
Denver, CO 80202
Phone (253) 733-4500

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1689827370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 16TH ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80202",
            "telephone_number": "303-876-7243",
            "fax_number": "866-917-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 N WEBB RD",
            "address_2": "SUITE B",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034057",
            "telephone_number": "308-382-0121",
            "fax_number": "308-382-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "FRANK",
        "authorized_official_first_name": "DERON",
        "authorized_official_title_or_position": "SENIOR VP",
        "authorized_official_telephone_number": "310-536-2402"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025674900",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nebraska Kidney Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.