Chattanooga Kidney Centers, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

CHATTANOOGA KIDNEY CENTERS, LLC

Practice address

2118 Stein Drive
Chattanooga, TN 37421-1691

Phone

(423) 648-4900

Fax

(423) 648-4906

NPI assigned

Jan 16, 2006

Last updated

Aug 3, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mandeep Grewal, M.D.NPI 1447256862

Title

Administrator

Phone

(423) 648-4900

Specialties & licenses 2

Addresses

Other identifiers 2

Practitioners 2

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.

• Mandeep S Grewal, MD

  • Nephrology Physician
  • Chattanooga, TN
  • NPI 1447256862
  NPD Authorized official
• Jackson J Yium, MD

  • Nephrology Physician
  • Chattanooga, TN
  • NPI 1467458885
  NPD (past)

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438560000000",
    "number": "1265411300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 BRAINERD ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113729",
            "telephone_number": "423-486-9510",
            "fax_number": "923-486-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 STEIN DRIVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211691",
            "telephone_number": "423-648-4900",
            "fax_number": "423-648-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATTANOOGA KIDNEY CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-16",
        "last_updated": "2015-08-03",
        "status": "A",
        "authorized_official_last_name": "GREWAL",
        "authorized_official_first_name": "MANDEEP",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-648-4900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TN",
            "license": "0000000138",
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003118324A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0442651",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chattanooga Hamilton County Hospital Authority (Dodson Avenue Community Health)
• Chattanooga Hamilton County Hospital Authority (Erlanger Medical Center)
• Chattanooga Hamilton County Hospital Authority (South Side Community Health)
• Chattanooga Hamilton County Hospital Authority
• Chattanooga Kidney Centers of North LLC
• Chattanooga Lung Specialists, LLC
• Chattanooga Medical Investors, Limited Partnership (LIfe Care Center of Chattanooga)
• Chattanooga Mobility Center, Inc.
• Chattanooga Neurology Associates PLLC
• Chattanooga OB GYN Group, PLLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.