SOUTHERN RENAL GROUP, INC. (NPI# 1376593319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376593319 |
| Entity Type | Organization |
| Organization Name | SOUTHERN RENAL GROUP, INC. |
| Other Organization Name | LINDBERGH DIALYSIS CENTER |
| Practice Address |
2695 Buford Hwy Ne Suite 108 Atlanta GA 30324-3278 |
| Practice Telephone | 4043150605 |
| Practice Fax Number | 4043150607 |
| Mailing Telephone | 4043150605 |
| Mailing Fax Number | 4043150607 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. BENEDICT EHIRIM (PRESIDENT) |
| Authorized Official Telephone | 4043150605 |
| 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 |
001254 | GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lindbergh Dialysis Center | Doing Business As Name - Organization |
| Street Address |
2695 BUFORD HWY NE SUITE 108 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30324-3278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508372905 | Rachel Silva | Dietitian, Registered | 2695 Buford Hwy Ne, Atlanta, GA 30324-3278 | 2017-12-20 |
| 1811338114 | Brookhaven Renal Systems, LLC | Clinic/Center | 2695 Buford Hwy Ne, Atlanta, GA 30324-3278 | 2013-07-15 |
| 1659562007 | Cidjah Rodney-somersall | Pediatrics | 2695 Buford Hwy Ne, Suite 200, Atlanta, GA 30324-3278 | 2007-08-08 |
| 1225104490 | Ana Maria Pimentel | Pediatrics | 2695 Buford Hwy Ne, Atlanta, GA 30324-3278 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174158919 | Marianella Anzola | Dietitian, Registered | Grady Brookhaven Health Center, 2695 Buford Hwy Ne 200, Atlanta, GA 30324 | 2020-03-11 |
| 1326515636 | Jacqueline Beckhom | Rehabilitation Counselor | Trinity Social Services, LLC 50 Lenox Pointe, Ne Suite, Atlanta, GA 30324 | 2018-10-25 |
| 1366925497 | David Wayne Richardson | Psychiatry & Neurology | 400 Rock Springs Road Ne, Atlanta, GA 30324 | 2018-09-14 |
| 1730625989 | Hwh, LLC | In Home Supportive Care | 1108 Pine Heights Dr Ne, Atlanta, GA 30324 | 2017-01-12 |
| 1780134403 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 2452 Morosgo Way Ne, Atlanta, GA 30324 | 2016-10-05 |
| 1063891372 | Jacqueline Nguyen | Family Medicine | 1125 Norwich Cir Ne, Atlanta, GA 30324 | 2015-05-20 |
| 1306277595 | Gerald Elroy Mitchell | Occupational Therapist | 1261 La Vista Road Ne, L - 4, Atlanta, GA 30324 | 2013-12-12 |
| 1487086138 | Continuum Care Group | Anesthesiology | 3574 Lenox Rd, 655, Atlanta, GA 30324 | 2013-08-05 |
| 1336589183 | Mary Azar Pride | Registered Nurse | 30-b Lenox Pte. N.e., Bldg 30 - Suite B, Atlanta, GA 30324 | 2013-06-26 |
| 1447594569 | Harley Anti-aging Institute LLC | Medical Genetics, Ph.D. Medical Genetics | 2678 Buford Highway Ne, Atlanta, GA 30324 | 2012-11-15 |
| Find all providers in zip 30324 | ||||
| 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 |
|---|---|---|---|---|
| 1013562818 | Menca Dialysis, LLC | Clinic/Center | 3030 Headland Dr Sw Ste C, Atlanta, GA 30311-5435 | 2019-08-08 |
| 1619475217 | Bio-medical Applications of Georgia, Inc. | Clinic/Center | 1149 Cascade Pkwy Sw, Atlanta, GA 30311-3090 | 2018-01-29 |
| 1114463601 | Total Renal Care Inc | Clinic/Center | 2045 Donald Lee Hollowell Pkwy Nw, Atlanta, GA 30318-4701 | 2017-01-09 |
| 1477985992 | Emory Dialysis, LLC | Clinic/Center | 5673 Peachtree Dunwoody Rd, Ne, Suite 501, Atlanta, GA 30342 | 2013-08-07 |
| 1558709816 | Total Renal Care Inc | Clinic/Center | 2540 Flat Shoals Rd, Atlanta, GA 30349-4314 | 2013-06-10 |
| 1295005742 | Total Renal Care Inc | Clinic/Center | 540 Central Ave Sw, Atlanta, GA 30312-2735 | 2011-12-30 |
| 1821367830 | Total Renal Care Inc | Clinic/Center | 413b Loop 59, Atlanta, TX 75551-2015 | 2011-12-20 |
| 1013142843 | Emory Dialysis, LLC | Clinic/Center | 610 Northside Dr Nw, Atlanta, GA 30318-6927 | 2009-05-22 |
| 1851594329 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 3651 Bakers Ferry Rd Sw, Atlanta, GA 30331-3712 | 2007-06-11 |
| 1417016551 | South Fulton Dialysis Center LLC | Clinic/Center | 3268 Greenbriar Pkwy Sw, Atlanta, GA 30331-2604 | 2006-12-06 |
| Find all providers in ATLANTA | ||||
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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.