NPIMap

Organization Active NPI

Community Dialysis Center of Columbus

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Columbus, GA
National Provider Identifier
1992809172
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
ESRD001243 Issued in GA
Legal business name
COMMUNITY DIALYSIS CENTER OF COLUMBUS
Practice address
1120 13TH Street
Columbus, GA 31901
Phone
(706) 507-0004
NPI assigned
Sep 11, 2006
Last updated
Apr 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Authorized official

Name
Dr. Ravindra Agarwal, M.D.NPI 1891753190
Title
President
Phone
(706) 494-8900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X ESRD001243 GA Primary

Addresses

Primary practice location

1120 13TH Street
Columbus, GA 31901

Mailing address

1120 13TH Street
Columbus, GA 31901
Phone (706) 507-0004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992809172. Details of each certification follow.

  • CCN 112748 End-stage renal disease facility · Active · Name & address match · Details

End-stage renal disease facility certification: CCN 112748

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COMMUNITY DIALYSIS CENTER OF COLUMBUS, LLC
Certification status
Active
Provider type (POS)
End-stage renal disease facility
Participating since
Mar 30, 2005
Last certification
Oct 30, 2019
Ownership / control type
For Profit
Facility address
1120-13TH Street
Columbus, GA 31901

National Provider Directory

National Provider Directory

Locations

1120 13th St
Columbus, GA 31901
Phone (706) 494-8900

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1992809172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 13TH STREET",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31901",
            "telephone_number": "706-507-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 13TH STREET",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31901",
            "telephone_number": "706-507-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DIALYSIS CENTER OF COLUMBUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "AGARWAL",
        "authorized_official_first_name": "RAVINDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-494-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "GA",
            "license": "ESRD001243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.