CENTRAL GEORGIA DIALYSIS LLC (NPI# 1073582425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073582425 |
| Entity Type | Organization |
| Organization Name | CENTRAL GEORGIA DIALYSIS LLC |
| Other Organization Name | EAST MACON DIALYSIS CENTER |
| Practice Address |
165 Emery Hwy Suite 101 Macon GA 31217 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 4787551144 |
| Practice Fax Number | 4787551127 |
| Mailing Telephone | 6153204268 |
| Mailing Fax Number | 8772380567 |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2018-07-23 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334500 |
| 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 |
ESRD001047 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 110252752A | 05 |
| Other Name | Type Code |
|---|---|
| East Macon Dialysis Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922076108 | Central Georgia Dialysis LLC | Clinic/Center | 1027 Keith Dr, Perry, GA 31069 | 2006-03-14 |
| Street Address |
165 EMERY HWY SUITE 101 |
| City | MACON |
| State | GA |
| Zip Code | 31217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851392476 | Renal Physicians of Georgia PC | Specialist | 165 Emery Hwy, 100, Macon, GA 31217-3666 | 2005-08-04 |
| 1851772867 | Amy Williams | Nurse Practitioner | 165 Emery Hwy, Suite 100, Macon, GA 31217-3600 | 2015-06-16 |
| 1841368933 | Carlos O Martinez | Internal Medicine | 165 Emery Hwy, Ste 100, Macon, GA 31217-3666 | 2006-11-30 |
| 1215951298 | Chanty Denise Davis | Internal Medicine | 165 Emery Hwy, Suite 100, Macon, GA 31217-3666 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326535998 | Khuzema Mohsin | Student in an Organized Health Care Education/Training Program | 380 Hospital Drive, Building A, Suite 430, Macon, GA 31217 | 2018-04-18 |
| 1083135271 | Angela Polk | Nurse Practitioner | 310 Hospital Dr Ste 305, Macon, GA 31217 | 2017-06-28 |
| 1235662305 | Natalie Rodziewicz | Student in an Organized Health Care Education/Training Program | 380 Hospital Drive, Suite 430, Macon, GA 31217 | 2017-04-06 |
| 1427430180 | Brett Forehand | Nurse Practitioner | 330 Hospital Dr Ste 304, Macon, GA 31217 | 2015-06-18 |
| 1376772640 | Beverly Barksdale Sanders IIi | Internal Medicine | 330 Hospital Dr., Ste. 304, Macon, GA 31217 | 2009-07-08 |
| 1528218393 | Vladimir Zahradnik | Surgery | 380 Hospital Dr Bldg A Ste 320, Macon, GA 31217 | 2008-09-29 |
| 1821274267 | Mary Charmaine Estrella Campana | Physical Therapist | 380 Hospital Drive, Building A, Ste. 430, Macon, GA 31217 | 2008-01-16 |
| 1033300785 | Joann Sams Sinclair | Nurse Practitioner | 4164 Riggins Mill Road, Macon, GA 31217 | 2007-08-07 |
| 1376689737 | Grier Godfrey | Dentist | Macon-bibb County Health Department, 171 Emery Highway, Macon, GA 31217 | 2007-01-30 |
| 1053408328 | Sujatha K. Reddy | Psychiatry & Neurology | 175 Emery Highway, Macon, GA 31217 | 2006-10-06 |
| Find all providers in zip 31217 | ||||
| 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 |
|---|---|---|---|---|
| 1265058275 | Dialysis Care Center Pleasant Hill LLC | Clinic/Center | 1425 Georgia Ave Ste 102, Macon, GA 31201-6546 | 2020-06-25 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1396257010 | Leawood Dialysis LLC | Clinic/Center | 640 Martin Luther King Jr Blvd Ste 100, Macon, GA 31201-3297 | 2017-11-03 |
| 1699298794 | Macon Eastside Dialysis Center LLC | Clinic/Center | 640 North Ave Ste H, Macon, GA 31211-1455 | 2017-07-20 |
| 1881080950 | Dsi Macon, LLC | Clinic/Center | 657 Hemlock St Ste 100, Macon, GA 31201-8331 | 2015-04-15 |
| 1073910485 | Macon Southside Dialysis Center LLC | Clinic/Center | 2117 Eisenhower Pkwy, Macon, GA 31206-3185 | 2014-12-01 |
| 1891194783 | Dialysis Clinic Inc | Clinic/Center | 1203 N. Missouri St, Macon, MO 63552 | 2014-08-18 |
| 1962825844 | Georgia Kidney Institute,llc | Clinic/Center | 1625 Hardeman Ave, Macon, GA 31201-1417 | 2014-01-28 |
| 1598877300 | Bio-medical Applications of Georgia Inc | Clinic/Center | 2500 2nd St, Macon, GA 31206-2224 | 2006-08-31 |
| 1114039948 | Bio-medical Applications of Georgia Inc | Clinic/Center | 280 Clinton St, Macon, GA 31217-3954 | 2006-08-31 |
| Find all providers in MACON | ||||
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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.