NPIMap

Organization Active NPI

Tuscaloosa Nephrology Associates PC

  • Nephrology Physician
  • Tuscaloosa, AL
National Provider Identifier
1215020318
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
TUSCALOOSA NEPHROLOGY ASSOCIATES PC
Practice address
1850 McFarland Blvd N
Tuscaloosa, AL 35406-2138
Phone
(205) 556-5541
Fax
(205) 554-7937
NPI assigned
Oct 2, 2006
Last updated
May 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Authorized official

Name
Dr. Dirk Berry, MDNPI 1831282938
Title
President MD
Phone
(205) 556-5541

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 Physician 207RN0300X NU Primary

Addresses

Primary practice location

1850 McFarland Blvd N
Tuscaloosa, AL 35406-2138

Mailing address

1850 McFarland Blvd N
Tuscaloosa, AL 35406-2138
Phone (205) 556-5541

Other identifiers 2

IdentifierTypeStateIssuer
528903280MedicaidAL
CN3399OtherALMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051130000754 AL Part B Supplier - Clinic/Group Practice 0547280968 Receives reassigned benefits from 10 practitioners
Practice locations: Tuscaloosa, AL

National Provider Directory

National Provider Directory

Locations

1850 McFarland Blvd N
Tuscaloosa, AL 35406
Phone (205) 556-5541

535 Jack Warner Pkwy NE
Ste K
Tuscaloosa, AL 35404
Phone (205) 556-5541

Practitioners & affiliated clinicians

Practitioners 11

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1215020318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 MCFARLAND BLVD N",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062138",
            "telephone_number": "205-556-5541",
            "fax_number": "205-554-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 MCFARLAND BLVD N",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062138",
            "telephone_number": "205-556-5541",
            "fax_number": "205-554-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUSCALOOSA NEPHROLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "DIRK",
        "authorized_official_title_or_position": "PRESIDENT MD",
        "authorized_official_telephone_number": "205-556-5541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528903280",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CN3399",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.