Ebenezer Adeboye Dawodu, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

100910 Issued in GA

Practice address

601A Professional Drive
Suite 235
Lawrenceville, GA 30046

Phone

(470) 292-3957

Fax

(470) 292-3683

NPI assigned

Apr 27, 2018

Last updated

Feb 20, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kidney Care Center Gwinnett LLCGroup PAC ID 0042544652, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kidney Care Center Gwinnett LLC

  • Nephrology Physician
  • Lawrenceville, GA
  • NPI 1487210316
  Medicare reassignment Care Compare group NPD
• Dialysis Care Center Duluth LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Duluth, GA
  • NPI 1346004348
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastside Medical Center, LLC

  dba Piedmont Eastside Medical Center

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Duluth

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1962990648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3877",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604343877",
            "telephone_number": "815-714-7171",
            "fax_number": "815-435-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601A PROFESSIONAL DRIVE",
            "address_2": "SUITE 235",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "470-292-3957",
            "fax_number": "470-292-3683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3980 Rogers Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300972214",
            "country_code": "US",
            "telephone_number": "470-292-3957",
            "fax_number": "470-292-3683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWODU",
        "first_name": "EBENEZER",
        "middle_name": "ADEBOYE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-27",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "100910",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "100910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Kelley Davis, WHNP
• Shanita Davis
• Versie Elder Davis, RN,CNS
• Victoria L Davis, CCC- SLP
• Gabrielle Dawkins, M.D.
• Esther Modupe Day, AGPCNP-BC
• Frank Reece Day Jr., O.D.
• Kelly Calvert Day, LICENSED SPEECH/LANG
• Stephen Alan Dayan, M.D.
• Omar Daye

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.