Champion Healthcare and Nephrology, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

48067 Issued in GA

Legal business name

CHAMPION HEALTHCARE AND NEPHROLOGY, LLC

Practice address

7525 Covington Hwy
Suite D
Lithonia, GA 30058-7439

Phone

(770) 484-4842

Fax

(770) 484-9595

NPI assigned

Dec 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mary Ardesar Morrow, M.D.

Title

Owner/Ceo

Phone

(770) 484-4842

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Mary Ardesar Morrow-Sutton, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Hershey, PA
  • NPI 1053411561
  NPD

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198627200000",
    "number": "1902080062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 COVINGTON HWY",
            "address_2": "SUITE D",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587439",
            "telephone_number": "770-484-4842",
            "fax_number": "770-484-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 COVINGTON HWY",
            "address_2": "SUITE D",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587439",
            "telephone_number": "770-484-4842",
            "fax_number": "770-484-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION HEALTHCARE AND NEPHROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ARDESAR",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "770-484-4842",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "48067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.