Impact Physician Group Nephrology, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

IMPACT PHYSICIAN GROUP NEPHROLOGY, LLC

Practice address

1585 Perry Worth Rd
Lebanon, IN 46052-9635

Phone

(765) 482-6391

NPI assigned

Jun 27, 2025

Organization subpart

No

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

Authorized official

Name

Paul Miller, CEO

Title

Ceo

Phone

(678) 699-4977

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anton Alexi Cabellon, D.O.

  • Nephrology Physician
  • Indianapolis, IN
  • NPI 1013006972
  Medicare reassignment NPD
• Saif M Choudhury, M.D.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1447540943
  Medicare reassignment NPD
• Sheryar Sarwar, MD

  • Family Medicine Physician
  • Kokomo, IN
  • NPI 1730426958
  Medicare reassignment NPD

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1003704875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 EASTBROOK BND STE 218",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691546",
            "telephone_number": "678-967-5599",
            "fax_number": "678-603-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 PERRY WORTH RD",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460529635",
            "telephone_number": "765-482-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT PHYSICIAN GROUP NEPHROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-699-4977",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Jason Hornbecker, MD
• Hadley Grace Whicker Howard, PHARMD
• Bruce Huckstep, RPH
• Christopher James Huffer, MD
• Abigail Hulen, LAT, ATC
• Indiana United Methodist Children'S Home
• Indiana University Eye Care, Inc.
• Noah Scott Ingalls
• Integrative Wellness, LLC
• Jackson County Schneck Memorial Hospital

• Nephrology Physician in Lebanon, IN
• Providers in Lebanon, IN by specialty
• Nephrology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.