GROVETOWN DIALYSIS CLINIC LLC (NPI# 1013141233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013141233 |
| Entity Type | Organization |
| Organization Name | GROVETOWN DIALYSIS CLINIC LLC |
| Other Organization Name | NEPHROLOGY CENTERS OF AMERICA - GROVETOWN |
| Practice Address |
444 Park West Dr Grovetown GA 30813-3216 |
| Practice Telephone | 7068633103 |
| Practice Fax Number | 7068631778 |
| Mailing Telephone | 7068633103 |
| Mailing Fax Number | 7068631778 |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2020-03-16 |
| Authorized Official Name | SHARI K COUSINS (SR. VP OF CLINICAL & REGULATORY) |
| Authorized Official Telephone | 9789223080 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000950617F | 05 |
| Other Name | Type Code |
|---|---|
| Nephrology Centers of America - Grovetown | Doing Business As Name - Organization |
| Street Address |
444 PARK WEST DR |
| City | GROVETOWN |
| State | GA |
| Zip Code | 30813-3216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043556814 | Caitlin Stallings Fealko | Occupational Therapist | 444 Park West Dr, Grovetown, GA 30813-3216 | 2012-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598276412 | Georgia Dental Professionals, PC | Dentist | 9596 Bentley Dr., Grovetown, GA 30813 | 2017-10-18 |
| 1558891895 | Jennifer M Humm | Dentist | 250 Merridian Drive, Grovetown, GA 30813 | 2017-06-19 |
| 1710335443 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 435 Lewiston Rd, Grovetown, GA 30813 | 2016-06-03 |
| 1558727214 | Lynda R Green | Counselor | 426 Northrop Place, Grovetown, GA 30813 | 2016-01-11 |
| 1689002610 | Patriots Park Dental, LLC | Dentist | 701 Devika Drive, Ste 10, Grovetown, GA 30813 | 2013-10-30 |
| 1255680096 | David Schulte Jr. | Internal Medicine | 925 Branch Ct Ste 2101, Grovetown, GA 30813 | 2012-09-07 |
| 1548519481 | Ashley Roberts Saunders | Pharmacist | 869 Horizon South Parkway, Grovetown, GA 30813 | 2012-09-06 |
| 1447569694 | Wallace Allen Partridge Jr. | Pharmacist | 5104 Wrightsboro Rd., Fred's Pharmacy 1699, Grovetown, GA 30813 | 2010-10-05 |
| 1497908149 | Sharon M Blair | Registered Nurse | 7640 Pleasantville Way, Grovetown, GA 30813 | 2008-10-28 |
| 1710160791 | Rebecca Meek | Nurse Practitioner | 469 Lewiston Rd, Grovetown, GA 30813 | 2007-12-12 |
| Find all providers in zip 30813 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598843393 | Nephrology Centers of America, LLC | Clinic/Center | 442 Park West Drive, Grovetown, GA 30813 | 2006-11-01 |
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|---|---|---|---|---|
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| 1083229280 | Bio- Medical Applications of Georgia, Inc. | Clinic/Center | 145 W Hendry St, Hinesville, GA 31313-3201 | 2020-09-14 |
| 1336759463 | Plattaz Dialysis, LLC | Clinic/Center | 100 Promenade Pkwy Ste C, Fayetteville, GA 30214-7735 | 2020-08-04 |
| 1174140743 | Home Dialysis Services Norcross LLC | Clinic/Center | 3780 Holcomb Bridge Rd Ste E, Norcross, GA 30092-4877 | 2020-06-30 |
| 1265058275 | Dialysis Care Center Pleasant Hill LLC | Clinic/Center | 1425 Georgia Ave Ste 102, Macon, GA 31201-6546 | 2020-06-25 |
| 1598389132 | Concerto Georgia LLC | Clinic/Center | 655 Exchange Cir Ste 100, Bethlehem, GA 30620-1767 | 2020-05-29 |
| 1629607098 | Rutledge Dialysis, LLC | Clinic/Center | 1719 New Hope Rd, Lawrenceville, GA 30045-6570 | 2020-04-07 |
| 1215562293 | Dialysis Clinic Inc | Clinic/Center | 1219 S. Martin Luther King Blvd., Americuse, GA 31719 | 2020-03-10 |
| 1659915882 | Filmore Dialysis, LLC | Clinic/Center | 4555 Atlanta Hwy Ste M, Loganville, GA 30052-2646 | 2019-10-31 |
| 1013562818 | Menca Dialysis, LLC | Clinic/Center | 3030 Headland Dr Sw Ste C, Atlanta, GA 30311-5435 | 2019-08-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.