NPIMap

Organization Active NPI

Athens Kidney Center P.C.

Doing business as Eatonton Kidney Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Eatonton, GA
National Provider Identifier
1699286526
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
ATHENS KIDNEY CENTER P.C.
Doing business as
Eatonton Kidney Center
Practice address
103 N Washington Ave
Eatonton, GA 31024-1142
Phone
(706) 543-6397
NPI assigned
Oct 18, 2017
Last updated
Sep 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Valarie Lumpkin
Title
Administrative Assistant
Phone
(706) 543-6397

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

103 N Washington Ave
Eatonton, GA 31024-1142

Mailing address

1440 N Chase St
Athens, GA 30601-1850
Phone (706) 543-6397

Other names 1

  • Eatonton Kidney Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180416002044 GA Part A Provider - End-Stage Renal Disease Facility (ESRD) 9739127036 Practice locations: Eatonton, GA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Eatonton Kidney CenterCCN 852539
Ownership
Non-profit
Certified
Apr 19, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
10

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Athens Kidney Center PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

103 N Washington Ave
Eatonton, GA 31024
Phone (706) 485-8591

98 Arthur St
Hartwell, GA 30643
Phone (706) 543-6397

1311 Atlanta Hwy
Ste A
Madison, GA 30650
Phone (706) 752-1113

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1699286526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 N CHASE ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306011850",
            "telephone_number": "706-543-6397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N WASHINGTON AVE",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310241142",
            "telephone_number": "706-543-6397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS KIDNEY CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-18",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "LUMPKIN",
        "authorized_official_first_name": "VALARIE",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "706-543-6397"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eatonton Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eatonton Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eatonton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.