Organization Active NPI

Nephron Corporation

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Gainesville, GA
National Provider Identifier
1770505877
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
NEPHRON CORPORATION
Doing business as
Northeast Georgia Dialysis Center
Practice address
440 South Enota St
Gainesville, GA 30501
Phone
(770) 962-1231
Fax
(770) 513-2107
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Authorized official

Name
Dr. Kirti K Shah, M.D.
Title
Medical Director
Phone
(770) 962-1231

Specialties & licenses 1

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

Addresses

Primary practice location

440 South Enota St
Gainesville, GA 30501

Mailing address

605 Old Norcross Rd
Lawrenceville, GA 30045
Phone (770) 962-1231

Other identifiers 2

IdentifierTypeStateIssuer
000857491AMedicaidGA
000857491BMedicaidGA

Other names 1

  • Northeast Georgia Dialysis Center Doing business as

National Provider Directory

National Provider Directory

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": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243814400000",
    "number": "1770505877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30045",
            "telephone_number": "770-962-1231",
            "fax_number": "770-513-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 SOUTH ENOTA ST",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-962-1231",
            "fax_number": "770-513-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHRON CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2009-06-01",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KIRTI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-962-1231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000857491A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000857491B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Georgia Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; 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.