Peachland Nephrology & Hypertension,PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

051570 Issued in GA

Legal business name

PEACHLAND NEPHROLOGY & HYPERTENSION,PC

Practice address

1668 Mulkey Rd
Suite G
Austell, GA 30106-1143

Phone

(770) 944-8494

Fax

(678) 945-7401

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nega Woldehawariat, M.D.NPI 1437210358

Title

Medical Officer

Phone

(770) 944-8494

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nega Woldehawariat, M.D.

  • Nephrology Physician
  • Austell, GA
  • NPI 1437210358
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740403690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 POWERS FERRY RD NW",
            "address_2": "SUITE 600-112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392919",
            "telephone_number": "770-944-8494",
            "fax_number": "678-945-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1668 MULKEY RD",
            "address_2": "SUITE G",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061143",
            "telephone_number": "770-944-8494",
            "fax_number": "678-945-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHLAND NEPHROLOGY & HYPERTENSION,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOLDEHAWARIAT",
        "authorized_official_first_name": "NEGA",
        "authorized_official_title_or_position": "MEDICAL OFFICER",
        "authorized_official_telephone_number": "770-944-8494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "051570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ritesh Patel, MD
• Sital Vijendra Patel, MD
• Sonya Patel, O.D.
• Thakorbhai Patel, MD
• Maria De Lourdes Pazmino
• Peachstreet Immediate Care Center
• Peachtree Staffing Alliance Inc
• Stephanie Renee Peanasky, PHARM.D.
• William Pearl
• Ashante Peeples, COTA/L

• Nephrology Physician in Austell, GA
• Providers in Austell, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.