Kidney Center of Ooltewah- Collegedale LLC

Primary specialty

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

Legal business name

KIDNEY CENTER OF OOLTEWAH- COLLEGEDALE LLC

Practice address

5483 Little Debbie Pkwy
Ooltewah, TN 37363-8409

Phone

(423) 541-3450

Fax

(423) 541-3451

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

Nathan Chamberlain, M.D.

Title

Administrator

Phone

(423) 443-2146

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John D McCarley, M.D.

  • Nephrology Physician
  • Chattanooga, TN
  • NPI 1760480321
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1316474182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 BRAINERD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113729",
            "telephone_number": "423-486-9514",
            "fax_number": "423-702-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5483 LITTLE DEBBIE PKWY",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373638409",
            "telephone_number": "423-541-3450",
            "fax_number": "423-541-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CENTER OF OOLTEWAH- COLLEGEDALE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "CHAMBERLAIN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-443-2146",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q050145",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan David Keller, LPC-MHSP
• Melissa G Kelley, PTA
• Darlene Kellogg, CNA
• Howard Michael Kennedy Jr., PA-C
• Janine Marie Kennedy, PA-C
• Eli Yong Kim, M.D.
• Amanda Kirkpatrick, RD, LDN
• Mark David Kirshner, C.PED, CO
• Klinner Enterprises
• Thomas Robert Klinner, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ooltewah, TN
• Providers in Ooltewah, 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 Dec 2, 2021; 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.