NPIMap

Organization Active NPI

Renal Associates of Mid-Michigan PC

  • Nephrology Physician
  • Midland, MI
National Provider Identifier
1194911941
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
RENAL ASSOCIATES OF MID-MICHIGAN PC
Practice address
415 W Wackerly St
Midland, MI 48640-2739
Phone
(989) 837-6505
Fax
(989) 835-8428
NPI assigned
Sep 14, 2007
Last updated
Dec 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Authorized official

Name
Adeel Khan, M.D.NPI 1467481465
Title
President
Phone
(989) 837-6505

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X MI
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MI
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X MI Primary

Addresses

Primary practice location

415 W Wackerly St
Midland, MI 48640-2739

Mailing address

415 W Wackerly St
Midland, MI 48640-2739
Phone (989) 837-6505

Other identifiers 1

IdentifierTypeStateIssuer
0E61173OtherMIBCBSM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080625000537 MI Part B Supplier - Clinic/Group Practice 3072684638 Receives reassigned benefits from 6 practitioners
Practice locations: Gaylord, MI; Gladwin, MI; Grayling, MI; Houghton Lake, MI; Midland, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1194911941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402739",
            "telephone_number": "989-837-6505",
            "fax_number": "989-835-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402739",
            "telephone_number": "989-837-6505",
            "fax_number": "989-835-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL ASSOCIATES OF MID-MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ADEEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-837-6505",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0E61173",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.