EAST GEORGIA NEPHROLOGY, PC – NPI #1215128186
Internal Medicine

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.

EAST GEORGIA NEPHROLOGY, PC is a provider located in STATESBORO, GA. NPPES has assigned the NPI number 1215128186 to EAST GEORGIA NEPHROLOGY, PC on August 06, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207RN0300X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Nephrology

The NPI profile was previously updated about 11 years ago on Nov 06, 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 EAST GEORGIA NEPHROLOGY, PC below.

NPI Profile for
EAST GEORGIA NEPHROLOGY, PC

NPI Number
1215128186
Enumeration Date

(about 19 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
EAST GEORGIA NEPHROLOGY, PC
Primary location
450 GEORGIA AVE
SUITE B
STATESBORO, GA 30458-5585
Phone: (912) 871-2200 Fax: (912) 871-2220
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JAMES JACKSON
OWNER
Phone: (912) 871-2200
Updated
Identifiers

Identifiers for EAST GEORGIA NEPHROLOGY, PC

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
OTHERRAILROAD MEDICAREGADN3298
MEDICAIDGA300034644A
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
207RN0300X
- Internal Medicine / Nephrology (Primary)
GA 034372

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.