KIDNEY DISEASE CONSULTANTS (NPI# 1669676383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669676383 |
| Entity Type | Organization |
| Organization Name | KIDNEY DISEASE CONSULTANTS |
| Practice Address |
47 Cavalier Blvd Suite 120 Florence KY 41042-3969 |
| Practice Telephone | 8595340861 |
| Practice Fax Number | 8595340865 |
| Mailing Telephone | 8595340861 |
| Mailing Fax Number | 8595340865 |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2013-04-11 |
| Authorized Official Name | DEEPAK MITTAL (PHYSICIAN) |
| Authorized Official Telephone | 8595340861 |
| 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 |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100040200 | 05 | |
| OH | 2843249 | 05 |
| Street Address |
47 CAVALIER BLVD SUITE 120 |
| City | FLORENCE |
| State | KY |
| Zip Code | 41042-3969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306841515 | Timothy J. Kappes | Physician Assistant | 47 Cavalier Blvd, Ste 100, Florence, KY 41042-3970 | 2005-06-15 |
| 1326674391 | Summer Marie Trenkamp | Nurse Practitioner | 47 Cavalier Blvd, Florence, KY 41042-3969 | 2020-03-21 |
| 1538404132 | Kumar Dialysis LLC | Clinic/Center | 47 Cavalier Blvd, Florence, KY 41042-3969 | 2012-12-07 |
| 1811231954 | Robert J Klickovich Md | Pain Medicine | 47 Cavalier Blvd, Suite 100, Florence, KY 41042-3969 | 2012-11-15 |
| 1548434947 | Interventional Pain Specialist | Registered Nurse | 47 Cavalier Blvd, Suite 100, Florence, KY 41042-3969 | 2008-04-16 |
| 1649204306 | Robert J Klickovich | Anesthesiology | 47 Cavalier Blvd, Ste 100, Florence, KY 41042-3969 | 2006-07-10 |
| 1447296538 | Deepak Mittal | Internal Medicine | 47 Cavalier Blvd, Suite 120, Florence, KY 41042-3969 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710596010 | Stacey Deann Cruse | Counselor | 71 Cavalier Blvd #303, Florance, KY 41042 | 2020-07-23 |
| 1760044705 | Loretta Macaluso | Speech-Language Pathologist | 1515 Cavalry Drive, Suite 202, Florence, KY 41042 | 2019-06-29 |
| 1659879559 | Christina Shrader | Counselor | 71 Cavalier Blvd Ste 113, Florence, KY 41042 | 2018-01-25 |
| 1891200267 | Rachel Knuehl | Case Manager/Care Coordinator | 8140 Dream Street, Florence, KY 41042 | 2017-12-07 |
| 1427560697 | Marie Nicole Sartori | Nurse Practitioner | 7766 Ewing Blvd Ste 100, Florence, KY 41042 | 2017-10-27 |
| 1669903910 | Northern Kentucky Smiles | Dentist | 1481 Cavalry Drive, Suite 100, Florence, KY 41042 | 2017-03-27 |
| 1306394937 | Mary Austin | Nurse Practitioner | 7766 Ewing Boulevard, Florence, KY 41042 | 2016-09-12 |
| 1598211633 | Samantha Growe | Counselor | 7000 Houston Rd Ste 16, Florence, KY 41042 | 2016-08-29 |
| 1982079299 | Jessica Adelyn Goodridge | Doula | 2224 Forest Lawn Dr., Florence, KY 41042 | 2015-12-11 |
| 1083083414 | Victoria Maruca Havron | Psychologist | 6900 Houston Rd Ste 11, Florence, KY 41042 | 2015-09-16 |
| Find all providers in zip 41042 | ||||
| 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 |
|---|---|---|---|---|
| 1285643809 | Barefoot Doctors Healthcare Florence Pllc | Internal Medicine | 822 E Saguaro St, Florence, AZ 85232 | 2006-08-05 |
| 1851309116 | Sompong Kraikit | Internal Medicine | 1120 Dunvegan Rd, Florence, SC 29501-5626 | 2006-08-03 |
| 1538158449 | Wen-ting Ouyang | Internal Medicine | 255 Warley St, Florence, SC 29501-4444 | 2005-10-14 |
| 1831730183 | Kidney Associates of The Tristate | Internal Medicine | 6909 Burlington Pike Ste B, Florence, KY 41042-1618 | 2019-10-07 |
| 1437541901 | Mcleod Physician Associates II | Internal Medicine | 101 S Ravenel St, Suite 120, Florence, SC 29506-2618 | 2015-02-20 |
| 1811385032 | Govindappa LLC | Internal Medicine | 121 E Cedar St, 4th Floor, Florence, SC 29506-2576 | 2014-12-23 |
| 1184880049 | Mhd Adnan Alsaka | Internal Medicine | 101 S Ravenel St, Suite 120, Florence, SC 29506-2618 | 2008-07-31 |
| 1316149412 | Ai Ngoc Tran | Internal Medicine | 6909 Burlington Pike Ste B, Florence, KY 41042-1618 | 2007-06-01 |
| 1598825929 | Pee Dee Nephrology LLP | Internal Medicine | 1100 E Cheves St, Florence, SC 29506-2708 | 2006-12-08 |
| 1316983729 | Venugopal Govindappa | Internal Medicine | 255 Warley St, Florence, SC 29501-4444 | 2006-06-22 |
| Find all providers in FLORENCE | ||||
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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.