Macon Eastside Dialysis Center LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

MACON EASTSIDE DIALYSIS CENTER LLC

Practice address

640 North Ave Ste H
Macon, GA 31211-1455

Phone

(478) 621-0542

Fax

(478) 621-0543

NPI assigned

Jul 20, 2017

Organization subpart

No

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

Authorized official

Name

Sara Anne Brady

Title

Chief Nursing Officer

Phone

(208) 371-7878

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783296000000",
    "number": "1699298794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 NORTH AVE STE H",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312111455",
            "telephone_number": "478-621-0542",
            "fax_number": "478-621-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 NORTH AVE STE H",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312111455",
            "telephone_number": "478-621-0542",
            "fax_number": "478-621-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACON EASTSIDE DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-20",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CHIEF NURSING OFFICER",
        "authorized_official_telephone_number": "208-371-7878"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M&E Pharmacy Services Inc
• Frank Mack
• Hannah Mackey, NP
• Macon Cardiovascular Institute
• Macon Dentist Office, PC
• Macon Electrophysiology Associates
• Macon Eye Surgery Center, LLC
• Macon Family Health Center Inc
• Macon Ga Orthodontics
• Macon Gastroenterology Anesthesia Associates LLC

• All providers in Macon, GA
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.