NPIMap

Organization Active NPI

Kidney Experts PLLC

Doing business as The Kidney Experts

  • Nephrology Physician
  • Dyersburg, TN
National Provider Identifier
1225529142
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
KIDNEY EXPERTS PLLC
Doing business as
The Kidney Experts
Practice address
1575 Parr Ave # B
Dyersburg, TN 38024
Phone
(731) 286-1510
NPI assigned
May 25, 2018
Last updated
Jun 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Authorized official

Name
Dr. Anna Jiyoung Lee-Mulay, MDNPI 1457762304
Title
Nephrologist
Phone
(201) 988-1199

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 Primary

Addresses

Primary practice location

1575 Parr Ave # B
Dyersburg, TN 38024

Mailing address

1575 Parr Ave # B
Dyersburg, TN 38024-3151
Phone (731) 286-1510

Other names 1

  • The Kidney Experts Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180901000002 TN Part B Supplier - Clinic/Group Practice 5597015131 Receives reassigned benefits from 16 practitioners
Practice locations: Covington, TN; Martin, TN; Jackson, TN; Dyersburg, TN
O20190911001798 MO Part B Supplier - Clinic/Group Practice 5597015131 Receives reassigned benefits from 3 practitioners
Practice locations: Kennett, MO

National Provider Directory

National Provider Directory

Locations

11762 Douglass St
Ste 103
Arlington, TN 38002
Phone (248) 304-7009

1575 Parr Ave
Ste B
Dyersburg, TN 38024
Phone (731) 286-1510

160 W University Pkwy
Ste C
Jackson, TN 38305
Phone (731) 286-1510

160 W University Pkwy
Ste Cd
Jackson, TN 38305

215 Hawks Rd
Ste 11
Martin, TN 38237
Phone (731) 286-1510

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529366400000",
    "number": "1225529142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 PARR AVE # B",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243151",
            "telephone_number": "731-286-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 PARR AVE # B",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "38024",
            "telephone_number": "731-286-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY EXPERTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-06-19",
        "status": "A",
        "authorized_official_last_name": "LEE-MULAY",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "JIYOUNG",
        "authorized_official_title_or_position": "NEPHROLOGIST",
        "authorized_official_telephone_number": "201-988-1199",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Kidney Experts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dyersburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.