DYERSBURG KIDNEY CLINIC, INC (NPI# 1821207911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821207911 |
| Entity Type | Organization |
| Organization Name | DYERSBURG KIDNEY CLINIC, INC |
| Practice Address |
16 Murray Guard Drive Jackson TN 38305 |
| Mailing Address |
640c Hwy 51 Bypass Dyersburg TN 38024 |
| Practice Telephone | 7316684284 |
| Mailing Telephone | 7316686907 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KANDALA RAM CHARY (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7316686907 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 281P00000X | Chronic Disease Hospital | ========= | TN | Hospitals |
| X | 282N00000X | General Acute Care Hospital | MD00000124 | TN | Hospitals |
| Street Address |
16 MURRAY GUARD DRIVE |
| City | JACKSON |
| State | TN |
| Zip Code | 38305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 281P00000X |
| Grouping | Hospitals |
| Classification | Chronic Disease Hospital |
| (1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes. |
| Notes: Source: (1) Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245672385 | University of Mississppi Medical Center | Chronic Disease Hospital | 2500 N State St # L002, Jackson, MS 39216 | 2013-07-17 |
| 1093149411 | University of Mississippi Medical Center | Chronic Disease Hospital | 2500 N State St, Jackson, MS 39216-4500 | 2013-08-22 |
| 1861747958 | Allegiance Health | Chronic Disease Hospital | 205 N East Ave, Jackson, MI 49201-1753 | 2012-07-16 |
| 1013014695 | Sonny Montgomery V A M Edical Center | Chronic Disease Hospital | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2006-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518186782 | University of Tennesse, Memphis | Chronic Disease Hospital | 165 River Bridge Ln Apt 201, Memphis, TN 38103-7905 | 2007-04-25 |
| 1184840373 | U. of Tennessee Gme | Chronic Disease Hospital | 920 Madison Ave Ste C50, Ut College of Medicine, Memphis, TN 38103-3493 | 2007-04-17 |
| 1225187669 | James H. Quillen Va Medical Center | Chronic Disease Hospital | 415 S Main Ave, Erwin, TN 37650-1119 | 2007-01-08 |
| 1124121017 | Donna Gail Burns | Chronic Disease Hospital | 1310 24th Avenue, South, Veterans Administeration Medical Center (vamc), Nashville, TN 37212 | 2006-09-06 |
| 1134590763 | Univ. Tn Health Science Center | Chronic Disease Hospital | 62 S Dunlap St, Memphis, TN 38103-4903 | 2015-10-08 |
| 1649434382 | Us Department of Veteran Affairs | Chronic Disease Hospital | 1056 E Raines Rd, Memphis, TN 38116-6337 | 2008-07-11 |
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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.