COMPREHENSIVE KIDNEY DISEASE CENTER, LLC (NPI# 1649574286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649574286 |
| Entity Type | Organization |
| Organization Name | COMPREHENSIVE KIDNEY DISEASE CENTER, LLC |
| Practice Address |
333 Whitesport Dr Sw Suite 205 Huntsville AL 35801-6454 |
| Practice Telephone | 2564893007 |
| Practice Fax Number | 2564893045 |
| Mailing Telephone | 2564893007 |
| Mailing Fax Number | 2564893045 |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2011-02-05 |
| Authorized Official Name | DR. AMISH B SHAH (MANAGER) |
| Authorized Official Telephone | 2564893007 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
25611 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE ID TYPE UNSPECIFIED | 051519633SHA | 01 |
| Street Address |
333 WHITESPORT DR SW SUITE 205 |
| City | HUNTSVILLE |
| State | AL |
| Zip Code | 35801-6454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750341400 | Qi Wan | Internal Medicine | 333 Whitesport Dr Sw, Suite 303, Huntsville, AL 35801-6454 | 2006-03-26 |
| 1134670052 | Christy Bradley Teachout | Nurse Practitioner | 333 Whitesport Dr Sw, Suite 104, Huntsville, AL 35801-6454 | 2016-10-14 |
| 1598213654 | Natalie Nichols Patterson | Nurse Practitioner | 333 Whitesport Dr Sw, Suite 103, Huntsville, AL 35801-6454 | 2016-09-19 |
| 1205219474 | Tiffany Lozovsky | Nurse Practitioner | 333 Whitesport Dr Sw, Unit 305, Huntsville, AL 35801-6454 | 2015-07-06 |
| 1578962932 | Alabama Children's Clinic | Pediatrics | 333 Whitesport Dr Sw, Suite 104, Huntsville, AL 35801-6454 | 2014-08-21 |
| 1417210725 | Carroll Hearing Associates, LLC | Audiologist | 333 Whitesport Dr Sw, Suite 302, Huntsville, AL 35801-6454 | 2012-06-21 |
| 1093031189 | Alan Dowd Md PC | Clinic/Center | 333 Whitesport Dr Sw, Suite 204, Huntsville, AL 35801-6454 | 2010-04-14 |
| 1619150034 | Cheryl C. Bazzle Md, PC | Internal Medicine | 333 Whitesport Dr Sw, Suite 103, Huntsville, AL 35801-6454 | 2007-12-07 |
| 1184818882 | Irma F. De Leon Md PC | Clinic/Center | 333 Whitesport Dr Sw, Suite 203, Huntsville, AL 35801-6454 | 2007-09-05 |
| 1497965206 | Irma May Avila Fernandez De Leon | Internal Medicine | 333 Whitesport Dr Sw, Suite 203, Huntsville, AL 35801-6454 | 2007-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422742 | Elena Mihaela Kruse | Nurse Practitioner | 415 Echurch St, Nw Suite 4, Huntsville, AL 35801 | 2020-09-18 |
| 1225657661 | Ashley Danielle Ford | Student in an Organized Health Care Education/Training Program | 301 Governors Drive Se, Huntsville, AL 35801 | 2020-04-15 |
| 1407417702 | Sasha J White | Specialist | 410 Governors Dr. Sw, Huntsville, AL 35801 | 2019-06-26 |
| 1003472978 | Gina Marie Delgado | Nurse Practitioner | Huntsville Hospital Cvicu, 101 Sivley Rd., Huntsville, AL 35801 | 2019-05-15 |
| 1366909863 | Lisa Starkey Suggs | Nurse Practitioner | 3500 Memorial Parkway S.w., Huntsville, AL 35801 | 2019-02-21 |
| 1902373277 | Kelly S Fisher LLC | Counselor | 300 Clinton Avenue, Suite 22 A, Huntsville, AL 35801 | 2018-10-25 |
| 1073097911 | Brittani B Hamrick | Psychologist | 203 Eastside Sq Ste C9, Huntsville, AL 35801 | 2018-09-17 |
| 1548748312 | Jane O. Orton, Licsw, LLC | Social Worker | 120 Holmes Ave Ne, Huntsville, AL 35801 | 2018-08-02 |
| 1184100661 | Regroup Psychological Services | Psychologist | 2006 Franklin St. Se, Suite 110, Huntsville, AL 35801 | 2018-07-17 |
| 1366968398 | Bennett Brent Smith | Physician Assistant | 825 Adams St. Se, Huntsville, AL 35801 | 2017-08-22 |
| Find all providers in zip 35801 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780007435 | Kidney Center of Walker County LLC | Internal Medicine | 102 Medical Park Ln, Suite A, Huntsville, TX 77340-4975 | 2014-01-31 |
| 1700945250 | Dave S Khurana | Internal Medicine | 102 Medical Park Lane, Suite A, Huntsville, TX 77340-4975 | 2006-12-08 |
| 1598737389 | Amish B Shah | Internal Medicine | 333 Whitesport Drive, Suite 205, Huntsville, AL 35801 | 2006-02-06 |
| 1568434769 | Rosanne Lamia Winn | Internal Medicine | 2325 Pansy St Sw, Suite E, Huntsville, AL 35801-3834 | 2006-02-02 |
| 1881666063 | Bruce M Diplacido | Internal Medicine | 2780 Bob Wallace Avenue, Suite E, Huntsville, AL 35805-4104 | 2006-02-02 |
| 1447419288 | David G Bains | Internal Medicine | 2780 Bob Wallace Ave Sw, Huntsville, AL 35805-4104 | 2008-06-06 |
| 1205020666 | Christopher M Abeid | Internal Medicine | 810 Franklin St Se, Suite A, Huntsville, AL 35801-4310 | 2007-08-29 |
| 1831258698 | Michael J Quadrini | Internal Medicine | 2780 Bob Wallace Avenue, Suite E, Huntsville, AL 35805-4104 | 2006-12-07 |
| 1497838627 | Huntsville Nephrology Associates | Internal Medicine | 201 Sivley Rd Sw, Huntsville, AL 35801-5134 | 2006-10-23 |
| 1831281849 | Huntsville Renal Clinic, PC | Internal Medicine | 810 Franklin St Se, Suite A, Huntsville, AL 35801-4311 | 2006-09-28 |
| Find all providers in HUNTSVILLE | ||||
| City | HUNTSVILLE |
| Zip Code | 35801 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.