MEDICARE: ATLANTIC KIDNEY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871526202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC KIDNEY CENTER LLC

Provider Business Mailing Address
First Line	:	4700 N CONGRESS AVE
Second Line	:	SUITE 106
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3284
Country	:	US
Telephone Number	:	561-845-2888
Fax Number	:	561-845-7282

Provider Business Practice Location Address
First Line	:	4700 N CONGRESS AVE
Second Line	:	SUITE 106
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3284
Country	:	US
Telephone Number	:	561-845-2888
Fax Number	:	561-845-7282

Authorized Official
Title or Position	:	CHIEF NURSING OFFICER
Name	:	SARA ANNE BRADY
Credential	:
Telephone Number	:	208-371-7878

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	05/18/2026

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1972564433 — ELAINE M FREDRICKSON APRN
Practice Location Address:

4700 N CONGRESS AVE , STE 103
WEST PALM BEACH, FL
33407-3284

Practice Phone: 561-255-3131
Practice Fax: 855-346-3451

1932130770 — MS. M RACHEL SCHARF MD
Practice Location Address:

4700 N CONGRESS AVE STE 103
WEST PALM BEACH, FL
33407-3284

Practice Phone: 561-627-8637
Practice Fax:

1023454063 — THE MEDICAL GROUP OF SOUTH FLORIDA, INC
Practice Location Address:

4700 N CONGRESS AVE STE 103
WEST PALM BEACH, FL
33407-3284

Practice Phone: 561-622-6111
Practice Fax: 561-622-1176

1669896056 — GLEN COGNAC LCSW
Practice Location Address:

4700 N CONGRESS AVE STE 104
WEST PALM BEACH, FL
33407-3284

Practice Phone: 561-316-8495
Practice Fax: 561-828-8531

1962816876 — MS. STEPHANIE AYITA KNUPPENBURG MD
Practice Location Address:

4700 N CONGRESS AVE STE 103
WEST PALM BEACH, FL
33407-3284

Practice Phone: 561-622-6111
Practice Fax: 855-215-9930

Directions to “ATLANTIC KIDNEY CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.