CARROLL COUNTY NEPHROLOGY PC NPI 1558403113

NPI Information

  • NPI: 1558403113
  • Provider Name: CARROLL COUNTY NEPHROLOGY PC
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Organization
  • Former Legal Business Name: CARROLL COUNTY NEPHROLOGY LLC
  • CLIA Number: 01D2313797
  • Address: 157 CLINIC AVENUE
    SUITE 203
    CARROLLTON, GA
    ZIP 30117
  • Phone: (770) 832-0429

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NPI Details

CARROLL COUNTY NEPHROLOGY PC is a nephrology internal medicine in Carrollton, 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. CARROLL COUNTY NEPHROLOGY PC NPI is 1558403113. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Carroll County Nephrology Llc.

The provider's business location address is:

157 CLINIC AVENUE
SUITE 203
CARROLLTON, GA
ZIP 30117
Phone: (770) 832-0429
Fax: (770) 838-9108

The provider's authorized official is Sandy V Beasley .
The authorized official title is Billing & Coding and has the following contact phone number (770) 832-0429.

The CLIA number assigned to this NPI record is 01D2313797 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/12/2007 and was last updated on 1/31/2008.

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
1207R00000XInternal MedicineNo
2207RN0300XInternal MedicineNephrologyYes

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
139BDBXNMEDICARE PIN

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: 3/30/2025

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