Active NPI
Kidney Experts PLLC
- Nephrology Physician
- Dyersburg, TN
National Provider Identifier
1225529142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- Legal business name
- KIDNEY EXPERTS PLLC
- Practice address
- 1575 Parr Ave # B
Dyersburg, TN 38024 - Phone
- (731) 286-1510
- NPI assigned
- May 25, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Anna Jiyoung Lee-Mulay, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, MO
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
1575 Parr Ave
Ste B
Dyersburg, TN 38024
Phone (731) 286-1510
160 W University Pkwy
Ste Cd
Jackson, TN 38305
160 W University Pkwy
Ste C
Jackson, TN 38305
Phone (731) 286-1510
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.
-
- Family Nurse Practitioner
- Jackson, TN
- NPI 1528241999
TN
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.