Kidney and Hypertension Care Mid-America LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

KIDNEY AND HYPERTENSION CARE MID-AMERICA LLC

Practice address

400 Maple Summit Rd
Jerseyville, IL 62052-2028

Phone

(314) 628-7750

NPI assigned

Feb 21, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Meher S Mallick, MDNPI 1093789034

Title

Owner

Phone

(314) 628-7750

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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

• Meher S Mallick, M.D.

  • Nephrology Physician
  • Saint Louis, MO
  • NPI 1093789034

  IL

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1114783859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 289",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630060289",
            "telephone_number": "314-628-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MAPLE SUMMIT RD",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522028",
            "telephone_number": "314-628-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY AND HYPERTENSION CARE MID-AMERICA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "MALLICK",
        "authorized_official_first_name": "MEHER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-628-7750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03609903",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Jordan
• Arturo Dungca Joson, M.D.
• Jennifer Julius
• Carrie H Kallal, MSN APRN
• Danielle Kanallakan
• Chelsie Kiel
• Isaac Thomas Kinney
• Tim C Kisabeth, MD
• Tanner Patrick Krumwiede, MS, LAT, ATC
• Ellen Kuebrich

• Nephrology Physician in Jerseyville, IL
• Providers in Jerseyville, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.