MIDTOWN MACON DIALYSIS CENTER – NPI #1720035819
Clinic/Center

MIDTOWN MACON DIALYSIS CENTER is an AHC clinic located in MACON, GA. NPPES has assigned the NPI number 1720035819 to MIDTOWN MACON DIALYSIS CENTER on May 27, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MIDTOWN MACON DIALYSIS CENTER” is a dba name, the actual legal business name for this organization is NRA MIDTOWN MACON GEORGIA LLC. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was previously updated about 11 years ago on Jul 22, 2015. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MIDTOWN MACON DIALYSIS CENTER below.

NPI Profile for
NRA MIDTOWN MACON GEORGIA LLC

NPI Number
1720035819
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NRA MIDTOWN MACON GEORGIA LLC
Doing Business As (dba): MIDTOWN MACON DIALYSIS CENTER
Primary location
657 HEMLOCK ST
SUITE 100
MACON, GA 31201-8329
Phone: (478) 742-8001 Fax: (478) 742-3608
Mailing address
1550 W. MCEWEN DRIVE
SUITE 500
FRANKLIN, TN 37067-1731
Phone: (615) 661-1100 Fax: (615) 507-3300
Organization Subpart
Yes - MIDTOWN MACON DIALYSIS CENTER is subpart of another organization.
Authorized Official
JON SUNDOCK
VICE PRESIDENT
Phone: (615) 507-3307
Updated
Identifiers

Identifiers for MIDTOWN MACON DIALYSIS CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERCLIA CERTIFICATE OF WAIVEGA11D1048766
MEDICAIDGA655442926A
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.