Kidney Center of Central Georgia, LLC
NPI 1962708891ActiveOrganization· Internal Medicine, Nephrology· Macon, GA
Internal Medicine, Nephrology in Macon, Georgia, registered in NPPES in February 2011. The authorized official on file is Rachael Denise Tisdale, Practice Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1962708891 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 10, 2011 |
| Last updated in NPPES | Jun 18, 2026 |
| Certified by provider | Jun 18, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine, Nephrology Primary | 207RN0300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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