KIDNEY CENTER OF CENTRAL GEORGIA, LLC – NPI #1962708891
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.

KIDNEY CENTER OF CENTRAL GEORGIA, LLC is a provider located in MACON, GA. NPPES has assigned the NPI number 1962708891 to KIDNEY CENTER OF CENTRAL GEORGIA, LLC on February 10, 2011. 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 last updated on Feb 11, 2026. 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 KIDNEY CENTER OF CENTRAL GEORGIA, LLC below.

NPI Profile for
KIDNEY CENTER OF CENTRAL GEORGIA, LLC

NPI Number
1962708891
Enumeration Date

(more than 15 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
KIDNEY CENTER OF CENTRAL GEORGIA, LLC
Primary location
657 HEMLOCK ST STE 200
MACON, GA 31201-8324
Phone: (478) 254-7353 Fax: (478) 254-7350
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
RACHAEL TISDALE
PRACTICE MANAGER
Phone: (478) 254-7353
Updated
Certification Date
Feb 11, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

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)

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.