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NORTH GEORGIA KIDNEY SPECIALISTS LLC NPI 1053416925


NPI Information

NPI: 1053416925
Provider Name: NORTH GEORGIA KIDNEY SPECIALISTS, LLC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
880 CANTON RD NE
SUITE 400
MARIETTA, GA
ZIP 30060
Phone: (770) 528-9788
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NORTH GEORGIA KIDNEY SPECIALISTS, LLC is a nephrology internal medicine in Marietta, GA. The provider is 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. NORTH GEORGIA KIDNEY SPECIALISTS, LLC NPI is 1053416925. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

880 CANTON RD NE
SUITE 400
MARIETTA, GA
ZIP 30060-283
Phone: (770) 528-9788
Fax: (770) 420-2229

The provider's authorized official is Manolo S Gallego .
The authorized official title is President/physician and has the following contact phone number (770) 528-9788.

The enumeration date for this NPI number is 9/14/2006 and was last updated on 7/15/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RN0300XInternal MedicineNephrology036745GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1I67498MEDICARE UPINGEORGIA
2233167541AMEDICAIDGEORGIA
3282117409AMEDICAIDGEORGIA
4555189352AMEDICAIDGEORGIA
5000960726FMEDICAIDGEORGIA
65511I130044MEDICARE PINGEORGIA
7202I393080MEDICARE PINGEORGIA
81285688283OTHERGEORGIAMUHAMMAD YASSER JABRI, M.D. INDIVIDUAL NPI #
9H39848MEDICARE UPINGEORGIA
1000691182ABMEDICAIDGEORGIA
111275520793OTHERGEORGIAGALLEGO INDIVIDUAL NPI
12G11649MEDICARE UPINGEORGIA
13I51195MEDICARE UPINGEORGIA
1411SCFCSMEDICARE PINGEORGIA
15GRP7186MEDICARE PINGEORGIA
16DD6106OTHERGEORGIAMEDICARE RAILROAD GROUP #
17I51262MEDICARE UPINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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