Kodali Nephrology and Hypertention Center LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

25MA06878300 Issued in NJ

Legal business name

KODALI NEPHROLOGY AND HYPERTENTION CENTER LLC

Practice address

2040 Millburn Ave
Suite 403
Maplewood, NJ 07040-3726

Phone

(973) 763-1100

Fax

(973) 763-1122

NPI assigned

Oct 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Padmaja Kodali, M.DNPI 1790747764

Title

Doctor

Phone

(973) 763-1100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Padmaja Kodali, MD

  • Nephrology Physician
  • Maplewood, NJ
  • NPI 1790747764
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1326236647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 MILLBURN AVE",
            "address_2": "SUITE 403",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403726",
            "telephone_number": "973-763-1100",
            "fax_number": "973-763-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 MILLBURN AVE",
            "address_2": "SUITE 403",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403726",
            "telephone_number": "973-763-1100",
            "fax_number": "973-763-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KODALI NEPHROLOGY AND HYPERTENTION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "KODALI",
        "authorized_official_first_name": "PADMAJA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "973-763-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA06878300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8348707",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• King Dave Home Care LLC
• Amanda Renee Kirpitch, MA, RD, CDCES
• Kenzie Kitcharoen, M.D.
• Heather Lynn Knight-Sabio, OTR/L
• Aura Knox-Mask
• Padmaja Kodali, MD
• Stephanie Koempel, LPC, LCADC
• Howard B. Kook, D.C.
• Joan Kritsky, L.C.S.W.
• Maureen Ilise Kritzer-Lange, MSW, LCSW

• Nephrology Physician in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; 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.