Active NPI
Georgia Kidney Institute LLC
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Macon, GA
National Provider Identifier
1962825844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- 055819
- Legal business name
- GEORGIA KIDNEY INSTITUTE LLC
- Practice address
- 1625 Hardeman Ave
Macon, GA 31201-1417 - Phone
- (478) 257-5200
- NPI assigned
- Jan 28, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Morufu Alausa, MD
- Title
- Chief Medical Director
- Phone
- (815) 714-7171
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | 055819 | GA | Primary |
Addresses
Primary practice location
1625 Hardeman Ave
Macon, GA 31201-1417
Mailing address
PO Box 3134
Joliet, IL 60434-3134
Phone (815) 714-7171
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962825844 | Other | GA | NPI |
| 003124971A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140410002295 | GA | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 1658503321 | Practice locations: Macon, GA |
National Provider Directory
National Provider DirectoryLocations
1625 Hardeman Ave
Macon, GA 31201
Phone (478) 474-2114
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nephrology Physician
- Joliet, IL
- NPI 1730135955
-
- Orthopaedic Surgery Physician
- Macon, GA
- NPI 1972543973
-
- Registered Nurse
- Macon, GA
- NPI 1699514885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390867200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1653436800000",
"number": "1962825844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3134",
"city": "JOLIET",
"state": "IL",
"postal_code": "604343134",
"telephone_number": "815-714-7171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1625 HARDEMAN AVE",
"city": "MACON",
"state": "GA",
"postal_code": "312011417",
"telephone_number": "478-257-5200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GEORGIA KIDNEY INSTITUTE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-01-28",
"last_updated": "2022-05-25",
"certification_date": "2022-05-25",
"status": "A",
"authorized_official_last_name": "ALAUSA",
"authorized_official_first_name": "MORUFU",
"authorized_official_title_or_position": "CHIEF MEDICAL DIRECTOR",
"authorized_official_telephone_number": "815-714-7171",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": "GA",
"license": "055819",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1962825844",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003124971A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Macon, GA
- Georgia Eye Care Center
- Georgia Family & Care Services, Inc.
- Georgia Heart & Vascular Center PC
- Georgia Heart Physicians LLC
- Georgia Interventional Pain Associates, LLC
- Georgia Magnetic Imaging Center LTD
- Georgia Medical Devices, LLC
- Georgia Medical Equipment & Supplies of Macon, Inc
- Georgia Medical Equipment, LLC
- Georgia Medical Group, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.