HAILU DEMISSACHEW (NPI# 1356401616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356401616 |
| Entity Type | Individual |
| Full Name | HAILU DEMISSACHEW |
| Credential | MD |
| Practice Address |
19 Redmond Rd Nw Rome GA 30165-1533 |
| Mailing Address |
221 Technology Pkwy Nw Rome GA 30165-1369 |
| Practice Telephone | 7062338504 |
| Practice Fax Number | 7062338505 |
| Mailing Telephone | 7622351000 |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2020-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
054072 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 413486161B | 05 | |
| GA | 413486161H | 05 | |
| GA | 413486161F | 05 | |
| GA | 413486161A | 05 | |
| GA | 413486161E | 05 | |
| GA | 413486161G | 05 | |
| GA | 413486161C | 05 | |
| GA | 413486161D | 05 |
| Street Address |
19 REDMOND RD NW |
| City | ROME |
| State | GA |
| Zip Code | 30165-1533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508406117 | Deanna Barge Cordle | Nurse Practitioner | 19 Redmond Rd Nw, Rome, GA 30165-1533 | 2020-01-11 |
| 1912559980 | Bridgett Danielle Buffington | Nurse Practitioner | 19 Redmond Rd Nw, Rome, GA 30165-1533 | 2019-07-10 |
| 1275000721 | Lisa Ann Mitchell | Nurse Practitioner | 19 Redmond Rd Nw, Rome, GA 30165-1533 | 2018-11-01 |
| 1841655586 | Valerie Ann Henslee | Nurse Practitioner | 19 Redmond Rd Nw, Rome, GA 30165-1533 | 2015-12-23 |
| 1871965368 | Jessica Nichole Doyle | Nurse Practitioner | 19 Redmond Rd Nw, Rome, GA 30165-1533 | 2015-10-23 |
| 1659613966 | Jenni Charity Wright | Nurse Practitioner | 19 Redmond Rd Nw, Rome, GA 30165-1533 | 2013-03-25 |
| 1356491104 | Mary Elizabeth Whelan | Dietitian, Registered | 19 Redmond Rd Nw, Rome, GA 30165-1533 | 2007-01-12 |
| 1831255520 | Laurie Deneese Buchholtz | Dietitian, Registered | 19 Redmond Rd Nw, Rome, GA 30165-1533 | 2006-12-28 |
| 1134281199 | Ritu Kumari Khurana | Internal Medicine | 19 Redmond Rd Nw, Rome, GA 30165-1533 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868775 | Heather Bowman | Physical Therapist | 600 Eagle, E Lake Dr, Rome, GA 30165 | 2020-07-13 |
| 1205451101 | Kristopher Nelson | Student in an Organized Health Care Education/Training Program | 4256, 304 Shorter Ave Nw #201, Rome, GA 30165 | 2020-06-16 |
| 1962061457 | Stuart Paul Shaklee | Occupational Therapy Assistant | 1356 Redmond Road, Rome, GA 30165 | 2019-06-10 |
| 1386001055 | Autumn Streetman | Counselor | 6 Mathis Drive, Rome, GA 30165 | 2016-01-26 |
| 1144695784 | Gabrador Milligan | Counselor | 6 Mathis Road, Rome, GA 30165 | 2015-12-08 |
| 1386041952 | Theresa Suits | Registered Nurse | 1 Woodbine Avenue, Rome, GA 30165 | 2014-11-26 |
| 1942561147 | Nicole C. Christian | Clinical Neuropsychologist | 305 Redmond Rd, Rome, GA 30165 | 2012-06-04 |
| 1679832711 | Niki Pareshkumar Bhavsar | Internal Medicine | 3041 Turner Mccall Blvd, Rome, GA 30165 | 2012-05-10 |
| 1285927491 | Amanda Fischer Reeves | Family Medicine | 304 Shorter Ave Nw Ste 102, Rome, GA 30165 | 2011-05-20 |
| 1033436647 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 4 Coosawattee Ave, Rome, GA 30165 | 2010-04-23 |
| Find all providers in zip 30165 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639437510 | Nomsa Musemwa | Internal Medicine | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2012-04-27 |
| 1932311123 | North Georgia Nephrology Associates PC | Internal Medicine | 20 Riverbend Dr Sw, Rome, GA 30161-6066 | 2007-05-03 |
| 1134281199 | Ritu Kumari Khurana | Internal Medicine | 19 Redmond Rd Nw, Rome, GA 30165-1533 | 2006-12-15 |
| 1104905074 | Hamid Reza Chimeh | Internal Medicine | 20 Riverbend Dr Sw, Rome, GA 30161-6066 | 2006-11-03 |
| 1417946419 | Jerry Marshall Littlefield | Internal Medicine | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2005-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053968511 | Gwinnett Nephrology LLC | Internal Medicine | 1567 Janmar Rd Ste 100, Snellville, GA 30078-0308 | 2019-08-20 |
| 1063070654 | Kidney Specialists of Georgia PC | Internal Medicine | 575 Professional Dr Ste 290, Lawrenceville, GA 30046-3347 | 2019-05-30 |
| 1295219103 | Renal Associates of Lagrange LLC | Internal Medicine | 1300 Lafayette Pkwy Ste D, Lagrange, GA 30241-2610 | 2018-09-18 |
| 1912484395 | Atlanta Kidney Care LLC | Internal Medicine | 1462 Montreal Rd Ste 214, Tucker, GA 30084-6931 | 2018-07-27 |
| 1932591948 | Georgia Renal and Hypertension Care Inc | Internal Medicine | 928 S Park St, Suite H, Carrollton, GA 30117-4501 | 2015-02-27 |
| 1316344492 | Oconee Nephrology Associates, Inc. | Internal Medicine | 700 Oglethorpe Ave., Suite B1, Athens, GA 30606 | 2014-12-04 |
| 1134524853 | Sheryl Cababat Caberto | Internal Medicine | 1648 Pierce Dr Ne, Atlanta, GA 30307 | 2014-10-23 |
| 1306265384 | Srikar Kumar | Internal Medicine | 250 Village Center Pkwy Ste 100, Stockbridge, GA 30281-9104 | 2014-04-07 |
| 1477995868 | Moti Samaki | Internal Medicine | 1500 Oglethorpe Ave Ste 500c, Athens, GA 30606-2184 | 2013-07-25 |
| 1902143233 | Barry Jay Rosenbaum | Internal Medicine | 2000 Castleway Dr Ne, Atlanta, GA 30345-3914 | 2013-01-07 |
| 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.