The Kidney Clinic

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

038414 Issued in GA

Legal business name

THE KIDNEY CLINIC

Practice address

2386 Clower St Ste C105
Snellville, GA 30078-6107

Phone

(678) 344-0334

Fax

(678) 344-0343

NPI assigned

Jul 1, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mazen A Abdalla, MDNPI 1467420893

Title

Physician

Phone

(678) 344-0334

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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

• Mazen A Abdalla, M.D.

  • Nephrology Physician
  • Snellville, GA
  • NPI 1467420893
  Medicare reassignment Care Compare group NPD Authorized official
• Sara Husain, M.D.

  • Nephrology Physician
  • Snellville, GA
  • NPI 1912285701
  Medicare reassignment Care Compare group NPD
• Divakar Jammalamadaka, MD

  • Nephrology Physician
  • Snellville, GA
  • NPI 1265699920
  Medicare reassignment Care Compare group NPD
• Abhinandan Reddy Pakanati, M.D

  • Nephrology Physician
  • Snellville, GA
  • NPI 1710256912
  Medicare reassignment Care Compare group NPD
• Tabria Colston, FNP-C

  • Family Nurse Practitioner
  • Snellville, GA
  • NPI 1417561002
  NPD
• Corinne B Ellis, FNP-C

  • Family Nurse Practitioner
  • Snellville, GA
  • NPI 1629882428
  NPD (past)

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783296000000",
    "number": "1811159718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2386 CLOWER ST",
            "address_2": "SUITE C-105",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786134",
            "telephone_number": "678-344-0334",
            "fax_number": "678-344-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2386 CLOWER ST STE C105",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786107",
            "telephone_number": "678-344-0334",
            "fax_number": "678-344-0343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4555 Atlanta Hwy",
            "address_purpose": "LOCATION",
            "city": "Loganville",
            "state": "GA",
            "postal_code": "300522646",
            "country_code": "US",
            "telephone_number": "678-344-0334",
            "fax_number": "678-344-0343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2399 Wall St SE",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300132187",
            "country_code": "US",
            "telephone_number": "678-344-0334",
            "fax_number": "678-344-0343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3370 Sugarloaf Pkwy Ste A1",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300445491",
            "country_code": "US",
            "telephone_number": "678-344-0334",
            "fax_number": "678-344-0343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10132 Carlin Drive",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300143651",
            "country_code": "US",
            "telephone_number": "678-344-0334",
            "fax_number": "678-344-0343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 Milstead Rd NE Ste 150",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300123857",
            "country_code": "US",
            "telephone_number": "678-344-0334",
            "fax_number": "678-344-0343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4805 Lawrenceville Hwy NW Ste 320",
            "address_purpose": "LOCATION",
            "city": "Lilburn",
            "state": "GA",
            "postal_code": "300473800",
            "country_code": "US",
            "telephone_number": "678-344-0334",
            "fax_number": "678-344-0343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE KIDNEY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A",
        "authorized_official_last_name": "ABDALLA",
        "authorized_official_first_name": "MAZEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "678-344-0334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "038414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR MAZEN ABDALLA,MD",
            "identifier": "1467420893",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00612752A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Snellville, GA
• Providers in Snellville, GA by specialty
• Medical Specialty 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.
• 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.