Macon Medical Group PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

MACON MEDICAL GROUP PC

Practice address

640 Martin Luther King Jr Blvd
Suite 200
Macon, GA 31201-3206

Phone

(478) 745-5455

Fax

(478) 745-2915

NPI assigned

Aug 2, 2006

Last updated

May 4, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ludwig V. Cavaliere, MDNPI 1952300469

Title

Physician/Co-Owner

Phone

(478) 745-5455

Specialties & licenses 1

Addresses

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 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher Chang, NP

  • Nurse Practitioner
  • Macon, GA
  • NPI 1457090110
  Medicare reassignment Care Compare group NPD
• Catherine Faircloth, NP

  • Nurse Practitioner
  • Macon, GA
  • NPI 1386320349

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Ahmad Azmi Kabbani, MD

  • Nephrology Physician
  • Macon, GA
  • NPI 1528328796
  Medicare reassignment Care Compare group NPD
• Heather Nicole Self, FNP-BC

  • Nurse Practitioner
  • Macon, GA
  • NPI 1336611714
  Medicare reassignment Care Compare group NPD
• Swathi Singanamala, MD

  • Nephrology Physician
  • Macon, GA
  • NPI 1023275617
  Medicare reassignment Care Compare group NPD
• Adam Norman Rhoades, PA-C

  • Medical Physician Assistant
  • Macon, GA
  • NPI 1659519692
  Medicare reassignment Care Compare group
• Ifeyinwa Anigbogu, MD

  • Nephrology Physician
  • Douglasville, GA
  • NPI 1720243751
  Medicare reassignment NPD
• Nicole Sade Bello, NP-C

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1851769293
  Medicare reassignment NPD
• Kamilah Adaria Griswold, FNP-C

  • Internal Medicine Physician
  • Warner Robins, GA
  • NPI 1669238994
  Medicare reassignment NPD
• Deepak Kadiyala, M.D

  • Critical Care Medicine (Internal Medicine) Physician
  • Macon, GA
  • NPI 1417129610

  Nephrology

  Medicare reassignment NPD
• Hannah Renee Harrell, PA-C

  • Medical Physician Assistant
  • Atlanta, GA
  • NPI 1962920249
  Medicare reassignment
• Azmi A Kabbani, MD

  • Nephrology Physician
  • Macon, GA
  • NPI 1376541078
  Medicare reassignment

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241395200000",
    "number": "1912914847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013206",
            "telephone_number": "478-745-5455",
            "fax_number": "478-745-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013206",
            "telephone_number": "478-745-5455",
            "fax_number": "478-745-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACON MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2009-05-04",
        "status": "A",
        "authorized_official_last_name": "CAVALIERE",
        "authorized_official_first_name": "LUDWIG",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PHYSICIAN/CO-OWNER",
        "authorized_official_telephone_number": "478-745-5455",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macon Gynecologic Oncology LLC
• Macon Healthcare LLC
• Macon Kidney Institute
• Macon Lung Center PC
• Macon Medical Clinic, LLC.
• Macon Northside Hospital, LLC (Piedmont Macon North Hospital)
• Macon Occupational Medicine (Navicent Employee Health Clinic)
• Macon Occupational Medicine
• Macon Operating LLC (Fountain Blue Rehab and Nursing)
• Macon Oral and Maxillofacial Surgery,P.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; 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.