NPIMap

Organization Active NPI

Northeast Alabama Kidney Clinic, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Talladega, AL
National Provider Identifier
1912019753
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
NORTHEAST ALABAMA KIDNEY CLINIC, INC.
Practice address
805 North St E
Talladega, AL 35160-2529
Phone
(256) 315-1662
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark Fawcett
Title
Treasurer
Phone
(781) 402-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

805 North St E
Talladega, AL 35160-2529

Mailing address

805 North St E
Talladega, AL 35160-2529

Other names 1

  • RCG TALLADEGA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Alabama Kidney Clinic Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912019753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 NORTH ST E",
            "city": "TALLADEGA",
            "state": "AL",
            "postal_code": "351602529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 NORTH ST E",
            "city": "TALLADEGA",
            "state": "AL",
            "postal_code": "351602529",
            "telephone_number": "256-315-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ALABAMA KIDNEY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "781-402-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RCG TALLADEGA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Talladega, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.