East Tennessee Nephrology PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

EAST TENNESSEE NEPHROLOGY PC

Practice address

2001 Laurel Ave
Ste 206
Knoxville, TN 37916-1865

Phone

(865) 524-3131

Fax

(865) 212-6323

NPI assigned

Aug 3, 2006

Last updated

Jul 2, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephen C Kiss, MDNPI 1770589988

Title

President MD

Phone

(865) 524-3131

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sung Yong Bae, M.D.

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1043443997
  Medicare reassignment Care Compare group NPD
• Gerald Scott Borrelli, M.D.

  • Nephrology Physician
  • Knoxville, TN
  • NPI 1871599084
  Medicare reassignment Care Compare group NPD
• Stephen C Kiss, MD

  • Nephrology Physician
  • Knoxville, TN
  • NPI 1770589988
  Medicare reassignment NPD Authorized official
• Stanislav Ozhog, D.O

  • Nephrology Physician
  • Knoxville, TN
  • NPI 1033579867
  Medicare reassignment Care Compare group NPD
• Laura Elizabeth Stamper, FNP

  • Nurse Practitioner
  • Knoxville, TN
  • NPI 1528924529
  Medicare reassignment Care Compare group NPD
• Jennifer R. Estes, PA-C

  • Physician Assistant
  • Knoxville, TN
  • NPI 1710642244
  Medicare reassignment Care Compare group
• Jimmy D Gentry II, M.D.

  • Nephrology Physician
  • Knoxville, TN
  • NPI 1467896365
  Medicare reassignment NPD
• Andrea Coppenger, NP

  • Family Nurse Practitioner
  • Maryville, TN
  • NPI 1851139828

  Nephrology

  NPD
• Ernest Brian Kemp, M.D.

  • Infectious Disease Physician
  • Knoxville, TN
  • NPI 1790764637
  NPD (past)
• Randolph M Lowry, M.D.

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1649371089
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1083622526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE",
            "address_2": "STE 206",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161865",
            "telephone_number": "865-524-3131",
            "fax_number": "865-212-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE",
            "address_2": "STE 206",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161865",
            "telephone_number": "865-524-3131",
            "fax_number": "865-212-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TENNESSEE NEPHROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "KISS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT MD",
        "authorized_official_telephone_number": "865-524-3131",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3721896",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Tennessee Heart Consultants, P.C.
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• East Tennessee Mobile Diagnostics LLC
• East Tennessee Neonatal Associates, P.C.
• East Tennessee Occupational Therapy Services, P.C. (Etots)
• East Tennessee Oral & Maxillofacial Surgery, PC
• East Tennessee Oral and Maxillofacial Surgery, PC
• East Tennessee Pediatric Cardiology, P.C.
• East Tennessee Pediatric Dentistry PLLC

• Nephrology Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Nephrology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.