Provider Demographics
NPI:1962429050
Name:KIDNEY CARE ASSOCIATES PLLC
Entity type:Organization
Organization Name:KIDNEY CARE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANUMEET
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIYADARSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:615-441-2889
Mailing Address - Street 1:256 BEASLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1824
Mailing Address - Country:US
Mailing Address - Phone:615-441-2889
Mailing Address - Fax:615-441-2881
Practice Address - Street 1:256 BEASLEY DRIVE
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1824
Practice Address - Country:US
Practice Address - Phone:615-441-2889
Practice Address - Fax:615-441-2881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41164207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3735095Medicare ID - Type Unspecified
TNI63946Medicare UPIN