{"npi":"1073582425","type":"NPI-2","status":"active","name":{"display":"Central Georgia Dialysis LLC","other":[],"organization_name":"CENTRAL GEORGIA DIALYSIS LLC","authorised_official":"Samuel Wey"},"specialty":{"primary_taxonomy":"261QE0700X","primary_taxonomy_description":"End-Stage Renal Disease (ESRD) Treatment Clinic/Center","slug":"end-stage-renal-disease-esrd-treatment-clinic-center","schema_org_specialty":null,"all":[{"code":"261QE0700X","description":"End-Stage Renal Disease (ESRD) Treatment Clinic/Center","primary":true,"state":"GA","license":"ESRD001047"}]},"addresses":[{"purpose":"LOCATION","street_1":"165 EMERY HWY STE 101","city":"MACON","state":"GA","postal_code":"312173617","country_code":"US","phone":"4787551144","fax":"4787551127"},{"purpose":"MAILING","street_1":"5200 VIRGINIA WAY","city":"BRENTWOOD","state":"TN","postal_code":"370277569","country_code":"US"}],"license":{"state":"GA","number":"ESRD001047"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"110252752A","state":"GA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20051014000341","type_code":"00-03","type_desc":"PART A PROVIDER - END-STAGE RENAL DISEASE FACILITY (ESRD)","state":"GA","pac_id":"8527083310"}]},"enumeration_date":"2006-03-17","last_updated":"2025-07-01","_meta":{"source":"NPPES","snapshot_date":"2025-07-01","doc_url":"https://findmynpi.com/api"}}