Usrc Powder Springs Home LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

USRC POWDER SPRINGS HOME LLC

Doing business as

U.S. Renal Care Northwest Georgia Home Dialysis

Practice address

3721 New Macland Rd Ste 100B
Powder Springs, GA 30127-2000

Phone

(470) 781-6220

Fax

(470) 781-6710

NPI assigned

Oct 8, 2020

Last updated

Oct 8, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Presdient

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• U.S. Renal Care Northwest Georgia Home Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

USRC Northwest Georgia Home DialysisCCN 852581

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Dec 17, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

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

Part of

US Renal Care Inc

Locations

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Afu Mohammad Abdul, MD

  • Nephrology Physician
  • Cartersville, GA
  • NPI 1285834838

  Dialysis facility

  Care Compare affiliation Name & address match
• Muhammad Rashid Ishaque, M.D.

  • Nephrology Physician
  • Cartersville, GA
  • NPI 1255528949

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1871190207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 631034",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631034",
            "telephone_number": "470-781-6220",
            "fax_number": "470-781-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 NEW MACLAND RD STE 100B",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272000",
            "telephone_number": "470-781-6220",
            "fax_number": "470-781-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC POWDER SPRINGS HOME LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESDIENT",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Northwest Georgia Home Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Judith E Ugorji
• Eseroghene Ukueku-Boyo, BS PHARMACY
• Kingsley Nwabuko Umezurike, PHARMD
• Upward Autism Center LLC
• Leah Avis Urben, RPH
• Mahaveer Vakharia, M.D.
• Susan Gail Vander Wyk, OTR
• Vensaee Investment (The Fraser Home)
• Veves Healthcare Services
• Vickyscrown Mobility Transport LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Powder Springs, GA
• Providers in Powder Springs, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.