NPIMap

Organization Active NPI

Nephrology Center of South Augusta

  • Skilled Nursing Facility
  • Augusta, GA
National Provider Identifier
1992910350
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
12414140 Issued in GA
Legal business name
NEPHROLOGY CENTER OF SOUTH AUGUSTA
Practice address
1631 Gordon Hwy Ste 1-B
Augusta, GA 30906-2221
Phone
(706) 790-8300
Fax
(706) 790-9944
NPI assigned
May 11, 2007
Last updated
Aug 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Authorized official

Name
Evette Myers, RN
Title
Facility Administrator
Phone
(706) 790-8300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 12414140 GA Primary

Addresses

Primary practice location

1631 Gordon Hwy Ste 1-B
Augusta, GA 30906-2221

Mailing address

1631 Gordon Hwy Ste 1-B
Augusta, GA 30906-2221
Phone (706) 790-8300

Other identifiers 2

IdentifierTypeStateIssuer
00409802AMedicaidGA
348887OtherGAWELLCARE

National Provider Directory

National Provider Directory
Tax ID family
Springdale Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1992910350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 GORDON HWY STE 1-B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062221",
            "telephone_number": "706-790-8300",
            "fax_number": "706-790-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 GORDON HWY STE 1-B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062221",
            "telephone_number": "706-790-8300",
            "fax_number": "706-790-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY CENTER OF SOUTH AUGUSTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "EVETTE",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "706-790-8300",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "12414140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00409802A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "348887",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.