DDS
NPI 1285066936
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Douglasvile, GA

NPI Status: Active since August 05, 2013

Contact Information

3138 GOLF RIDGE BLVD
DOUGLASVILE, GA
ZIP 30135
Phone: (770) 485-1773
Fax: (770) 627-3202

Get Directions Write a Review

  • Organization
  • Clinic/Center
  • End-Stage Renal Disease (ESRD) Treatment
  • CLIA Number: 11D0692446
  • CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
  • CLIA Exp. Date: 08-31-2026

About DDS

This page provides the complete NPI Profile along with additional information for Dds, a provider established in Douglasvile, Georgia operating as a Clinic/center, focusing in end-stage renal disease (esrd) treatment . The healthcare provider is registered in the NPI registry with number 1285066936 assigned on August 2013. The practitioner's primary taxonomy code is 261QE0700X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's is doing business as Dds. The authorized official of this NPI record is Ms. Jenell Harris (Facility Administrator)

NPI
1285066936
Provider Legal Name
DOUGLASVILLE DIALYSIS SPA DDS
Other Organization Name
DDS
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3138 GOLF RIDGE BLVD DOUGLASVILE, GA 30135
Location Phone
(770) 485-1773
Location Fax
(770) 627-3202
Mailing Address
1380 VETERAMS MEMORIAL HWY SW MABLETON, GA 30126
Mailing Phone
(770) 485-1773
Mailing Fax
(770) 627-3202
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-05-2013
Last Update Date
01-14-2016
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center End-Stage Renal Disease (ESRD) Treatment

Taxonomy Code
261QE0700X
Type
Ambulatory Health Care Facilities
License State
GA

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. JENELL HARRIS

Authorized Official Title
FACILITY ADMINISTRATOR
Authorized Official Phone
(678) 903-4470

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
112879MEDICARE OSCAR/CERTIFICATION (06)GA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
11D0692446
Facility Type
End Stage Renal Disease Dialysis Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
MOHAMMAD ANJUM
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Dds to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for DDS

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1285066936, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
5
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
9
Unchanged
Pos 9
3
Doubled → 6
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 0 → 0 6 → 12 → 3 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 6 + 5 + 0 + 6 + 1 + 2 + 9 + 6 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1285066936.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Marriage & Family Therapist
3138 GOLF RIDGE BLVD, SUITE 101
DOUGLASVILLE, GA 30135
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
3138 GOLF RIDGE BLVD
DOUGLASVILLE, GA 30135

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285066936, enumerated as an "organization" on August 05, 2013.

The provider is located at 3138 GOLF RIDGE BLVD DOUGLASVILE, GA 30135 and the phone number is (770) 485-1773.

Clinic/Center with taxonomy code 261QE0700X and a focus in End-Stage Renal Disease (ESRD) Treatment.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.