Kidney Focused Care, LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

KIDNEY FOCUSED CARE, LLC

Practice address

2633 Ridgewood Rd Ste 105
Jackson, MS 39216-4962

Phone

(601) 665-4429

Fax

(601) 665-4429

NPI assigned

Nov 15, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jacqueline Diane Boyd, NURSE PRACTITIONER

Title

Owner

Phone

(601) 665-4429

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1003418997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 PECAN CT",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390426012",
            "telephone_number": "662-719-9120",
            "fax_number": "601-665-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 RIDGEWOOD RD STE 105",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164962",
            "telephone_number": "601-665-4429",
            "fax_number": "601-665-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY FOCUSED CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-15",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-665-4429",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Primary Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.