Atlanta Kidney Care LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

ATLANTA KIDNEY CARE LLC

Practice address

5667 Peachtree Dunwoody Rd Ste 260
Atlanta, GA 30342-1714

Phone

(404) 255-1030

Fax

(678) 843-6619

NPI assigned

Nov 11, 2015

Organization subpart

No

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

Authorized official

Name

Ryan Valle

Title

President

Phone

(781) 699-9362

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Atlanta Nephrology Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 7

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

• Shaun David Conlon, M.D.

  • Nephrology Physician
  • Lawrenceville, GA
  • NPI 1760667034
  Medicare reassignment Care Compare group NPD
• Sarah Cubas

  • Family Nurse Practitioner
  • Atlanta, GA
  • NPI 1639803604
  Medicare reassignment Care Compare group NPD
• Srijita Kumar, M.D.

  • Nephrology Physician
  • Atlanta, GA
  • NPI 1437449741
  Medicare reassignment Care Compare group NPD
• Lananh Thi Nguyen, AGACNP-BC, DNP

  • Acute Care Nurse Practitioner
  • Atlanta, GA
  • NPI 1891338521
  Medicare reassignment Care Compare group NPD
• Susan C Hill, M.D.

  • Nephrology Physician
  • Atlanta, GA
  • NPI 1578643805
  Medicare reassignment NPD
• Tina Thomas, MD

  • Nephrology Physician
  • Houston, TX
  • NPI 1659627248

  GA

  Medicare reassignment NPD
• Hanif Boghani, MD

  • Specialist
  • Tucker, GA
  • NPI 1619026150
  NPD (past)

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1831562958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5667 PEACHTREE DUNWOODY RD STE 260",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421714",
            "telephone_number": "404-255-1030",
            "fax_number": "678-843-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5667 PEACHTREE DUNWOODY RD STE 260",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421714",
            "telephone_number": "404-255-1030",
            "fax_number": "678-843-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA KIDNEY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-11",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "VALLE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-699-9362"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003181580A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlanta Nephrology Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Atlanta Nephrology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Atlanta Lactation
• Atlanta Lactation
• Atlanta Life Journeys Services, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.