NORTHWEST NEPHROLOGY CLINIC NPI 1215052261

NPI Information

  • NPI: 1215052261
  • Provider Name: NORTHWEST NEPHROLOGY CLINIC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 11D1017535
  • Address: 5255 SNAPFINGER PARK DR
    SUITE 110
    DECATUR, GA
    ZIP 30035
  • Phone: (770) 981-2211

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NPI Details

NORTHWEST NEPHROLOGY CLINIC is a specialist in Decatur, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. NORTHWEST NEPHROLOGY CLINIC NPI is 1215052261. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5255 SNAPFINGER PARK DR
SUITE 110
DECATUR, GA
ZIP 30035-084
Phone: (770) 981-2211

The provider's authorized official is Andrew A Dixon .
The authorized official title is Physician and has the following contact phone number (770) 981-2211.

The CLIA number assigned to this NPI record is 11D1017535 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2007 and was last updated on 3/8/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist028761GEORGIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000702281GMEDICAIDGEORGIA
2103863411BMEDICAIDGEORGIA
3300030041BMEDICAIDGEORGIA
4103863411AMEDICAIDGEORGIA
5000441306EMEDICAIDGEORGIA

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: 11/21/2025

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