Fresenius Medical Care Dialysis of Golden Isles, LLC

Primary specialty

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

Legal business name

FRESENIUS MEDICAL CARE DIALYSIS OF GOLDEN ISLES, LLC

Practice address

475 Gateway Center Blvd
Brunswick, GA 31525-6742

Phone

(912) 265-0533

Fax

(912) 265-1752

NPI assigned

Jun 24, 2009

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

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

Authorized official

Name

Barry L. Blanton

Title

Vice President

Phone

(781) 699-9000

Specialties & licenses 1

Addresses

Other names 1

• FRESENIUS MEDICAL CARE DIALYSIS OF GOLDEN ISLES Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• National Medical Care, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bristol, TN
  • NPI 1477570117

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1982832309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 GATEWAY CENTER BLVD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315256742",
            "telephone_number": "912-265-0533",
            "fax_number": "912-265-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 GATEWAY CENTER BLVD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315256742",
            "telephone_number": "912-265-0533",
            "fax_number": "912-265-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE DIALYSIS OF GOLDEN ISLES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2009-06-24",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "BLANTON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "FRESENIUS MEDICAL CARE DIALYSIS OF GOLDEN ISLES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FRESENIUS MEDICAL CARE DIALYSIS OF GOLDEN ISLES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Coretta Foster
• Evan Hamilton Fountain, M.D.
• Chandler Fox, DPT
• Jamya Frazier
• Thomas Freney
• Friedrich Medical Center P.C.
• Eric William Friedrich II
• Amelia Harper Fritchman, MED CCC-SLP
• Adriana Fuel, IBCLC
• Nicole Shupe Fullard, NP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Brunswick, GA
• Providers in Brunswick, 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 17, 2023; 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.

Verify at the official NPI Registry.