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KIDNEY CENTER OF CENTRAL GEORGIA, LLC
NPI 1962708891
Internal Medicine - Nephrology in Macon, GA

Active since February 10, 2011
657 HEMLOCK ST STE 200, MACON, GA 31201(478) 254-7353(478) 254-7350 Get Directions Write a Review

NPPES record last updated: June 18, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kidney Center Of Central Georgia, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIDNEY CENTER OF CENTRAL GEORGIA, LLC (NPI 1962708891) is a healthcare organization registered as a nephrology in Macon, Georgia and active in the NPI registry since February 2011. The organization lists Rachael Denise Tisdale, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1962708891
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameKIDNEY CENTER OF CENTRAL GEORGIA, LLC
Location Address657 HEMLOCK ST STE 200Macon, GA 31201-8324
Mailing Address657 Hemlock St Ste 200Macon, GA 31201-8324 · (478) 461-3291 · Fax (478) 254-7353
Phone(478) 254-7353
Fax(478) 254-7350
Organization SubpartNo
Authorized OfficialRachael Denise TisdalePractice Manager · (478) 254-7353
Enumeration DateFebruary 10, 2011
Last NPPES UpdateJune 18, 2026
NPPES CertifiedJune 18, 2026
✔ NPI 1962708891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
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.
657 HEMLOCK ST STE 200, Macon, GA 31201
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kidney Center Of Central Georgia, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Kidney Center Of Central Georgia, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Ihab Zaggout, MD
Internal Medicine
NPI 1487774303
657 HEMLOCK ST SUITE 200
Macon, GA 31201
(478) 254-7353
✔ PECOS✔ Accepts MedicareSame address
Franklin Fuenmayor-Cardozo, M.D.
Internal Medicine
NPI 1467659854
2525 2ND ST STE 150
Macon, GA 31206
(478) 254-7353
✔ PECOS✔ Accepts Medicare1.4 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kidney Center Of Central Georgia, LLC's NPI number?

The NPI number for Kidney Center Of Central Georgia, LLC is 1962708891. It was assigned to this organization in the NPPES registry on February 10, 2011.

Where is Kidney Center Of Central Georgia, LLC located?

Kidney Center Of Central Georgia, LLC is located at 657 Hemlock St Ste 200, Macon, GA 31201. The listed phone number is (478) 254-7353.

What is Kidney Center Of Central Georgia, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Kidney Center Of Central Georgia, LLC enrolled in Medicare?

Yes. Kidney Center Of Central Georgia, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kidney Center Of Central Georgia, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Kidney Center Of Central Georgia, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Kidney Center Of Central Georgia, LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Kidney Center Of Central Georgia, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kidney Center Of Central Georgia, LLC was last updated on June 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.