NPIMap

Organization Active NPI

Advanced Dialysis Clinic LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jackson, TN
National Provider Identifier
1093043663
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
ADVANCED DIALYSIS CLINIC LLC
Practice address
170 Murray Guard Dr
Suite C
Jackson, TN 38305-3609
Phone
(731) 984-8390
Fax
(731) 984-8392
NPI assigned
Nov 19, 2009
Last updated
Nov 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Authorized official

Name
Dr. Shyamal Sarkar, MDNPI 1841260767
Title
President
Phone
(731) 984-8390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

170 Murray Guard Dr
Suite C
Jackson, TN 38305-3609

Mailing address

170 Murray Guard Dr
Suite C
Jackson, TN 38305-3609
Phone (731) 984-8390

National Provider Directory

National Provider Directory

Locations

170 Murray Guard Dr
Ste C
Jackson, TN 38305
Phone (731) 984-8390

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1093043663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MURRAY GUARD DR",
            "address_2": "SUITE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053609",
            "telephone_number": "731-984-8390",
            "fax_number": "731-984-8392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MURRAY GUARD DR",
            "address_2": "SUITE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053609",
            "telephone_number": "731-984-8390",
            "fax_number": "731-984-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DIALYSIS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "SARKAR",
        "authorized_official_first_name": "SHYAMAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "731-984-8390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.