NPIMap

Organization Active NPI

Kidney and Hypertension Specialists PLLC

  • Specialist
  • Jackson, MI
National Provider Identifier
1174649354
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
RN042337 Issued in MI
Legal business name
KIDNEY AND HYPERTENSION SPECIALISTS PLLC
Practice address
900 E Michigan Ave
Ste 104
Jackson, MI 49201-2457
Phone
(517) 788-7866
Fax
(517) 796-9339
NPI assigned
Mar 21, 2007
Last updated
Jul 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Authorized official

Name
Dr. Reddivalem Venkata Nagesh, MDNPI 1730122367
Title
Managing Partner
Phone
(517) 788-7866

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
Specialist 174400000X RN042337 MI Primary

Addresses

Primary practice location

900 E Michigan Ave
Ste 104
Jackson, MI 49201-2457

Mailing address

900 E Michigan Ave
Ste 104
Jackson, MI 49201-2457
Phone (517) 788-7866

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050107000833 MI Part B Supplier - Clinic/Group Practice 0244288025 Receives reassigned benefits from 5 practitioners
Practice locations: Albion, MI; Jackson, MI; Jonesville, MI

National Provider Directory

National Provider Directory

Locations

109 S Elm Ave
Jackson, MI 49203
Phone (517) 788-7866

900 E Michigan Ave
Ste 104
Jackson, MI 49201
Phone (517) 788-7866

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1174649354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E MICHIGAN AVE",
            "address_2": "STE 104",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012457",
            "telephone_number": "517-788-7866",
            "fax_number": "517-796-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E MICHIGAN AVE",
            "address_2": "STE 104",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012457",
            "telephone_number": "517-788-7866",
            "fax_number": "517-796-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY AND HYPERTENSION SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "NAGESH",
        "authorized_official_first_name": "REDDIVALEM",
        "authorized_official_middle_name": "VENKATA",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "517-788-7866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "RN042337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.