NPIMap

Organization Active NPI

Nephron Corporation

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Duluth, GA
National Provider Identifier
1962658807
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
NEPHRON CORPORATION
Practice address
3770 Howell Ferry Road
Duluth, GA 30096
Phone
(678) 495-0410
Fax
(678) 495-0408
NPI assigned
Aug 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Authorized official

Name
Dr. Kirti K Shah, MD
Title
Medical Director
Phone
(770) 962-1231

Specialties & licenses 1

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

Addresses

Primary practice location

3770 Howell Ferry Road
Duluth, GA 30096

Mailing address

605 Old Norcross Road
Lawrenceville, GA 30046
Phone (770) 962-1231

Other names 1

  • Duluth Dialysis Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080919000294 GA Part A Provider - End-Stage Renal Disease Facility (ESRD) 0749241214 Practice locations: Duluth, GA

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Duluth Dialysis CenterCCN 112809
Ownership
Profit
Certified
Apr 3, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Other
Dialysis stations
15

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1099369Duluth Dialysis Center3770 Howell Perry Road, Duluth, GA 30096Certificate of waiverMay 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Nephron Corporation8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296691200000",
    "number": "1962658807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 OLD NORCROSS ROAD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "770-962-1231",
            "fax_number": "678-325-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3770 HOWELL FERRY ROAD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "678-495-0410",
            "fax_number": "678-495-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHRON CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2011-02-03",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KIRTI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-962-1231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "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": "Duluth Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; 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.