NPIMap

Organization Active NPI

Kidney Care Center, PLLC

  • Nephrology Physician
  • Little Rock, AR
National Provider Identifier
1124142971
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
KIDNEY CARE CENTER, PLLC
Practice address
500 S. University
Suite 508
Little Rock, AR 72205
Phone
(208) 236-1600
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Muhammad G. Alam, M.D.NPI 1932202819
Title
President
Phone
(501) 772-3018

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X AR Primary

Addresses

Primary practice location

500 S. University
Suite 508
Little Rock, AR 72205

Mailing address

P.O. Box 4908
Pocatello, ID 83205
Phone (208) 236-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000432 AR Part B Supplier - Clinic/Group Practice 7416048772 Receives reassigned benefits from 8 practitioners
Practice locations: Little Rock, AR

National Provider Directory

National Provider Directory

Locations

500 S University Ave
Ste 505
Little Rock, AR 72205
Phone (501) 588-1100

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124142971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 4908",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83205",
            "telephone_number": "208-236-1600",
            "fax_number": "208-236-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S. UNIVERSITY",
            "address_2": "SUITE 508",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "208-236-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CARE CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALAM",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-772-3018",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.