Active NPI
Nephron Corporation
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Gainesville, GA
National Provider Identifier
1770505877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000857491A | Medicaid | GA | |
| 000857491B | Medicaid | GA |
Other names 1
- Northeast Georgia Dialysis Center
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nephrology Physician
- Dublin, GA
- NPI 1639105620
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.