Renalsouth of Rome LLC

Primary specialty

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

License

ESRD000684 Issued in GA

Legal business name

RENALSOUTH OF ROME LLC

Doing business as

RenalSouth

Practice address

315 W 10TH St NE
Suite 105
Rome, GA 30165-2676

Phone

(706) 314-9170

Fax

(855) 687-9673

NPI assigned

Feb 27, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Janet Renae Brown

Title

Coo

Phone

(205) 815-6541

Specialties & licenses 1

Addresses

Other names 1

• RenalSouth Doing business as

Locations

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412812800000",
    "number": "1952726945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 GEMINI CIR",
            "address_2": "SUITE 418",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352095874",
            "telephone_number": "205-815-6541",
            "fax_number": "855-291-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 10TH ST NE",
            "address_2": "SUITE 105",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652676",
            "telephone_number": "706-314-9170",
            "fax_number": "855-687-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENALSOUTH OF ROME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-27",
        "last_updated": "2014-10-09",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "RENAE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "205-815-6541",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "GA",
            "license": "ESRD000684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RenalSouth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Rome, GA
• Providers in Rome, 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 9, 2014; 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.