Kidney Clinic Cordele LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

KIDNEY CLINIC CORDELE LLC

Practice address

106 W 4TH Ave
Cordele, GA 31015-3214

Phone

(615) 695-9292

NPI assigned

Mar 26, 2021

Organization subpart

No

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

Authorized official

Name

Brenda H Lepley

Title

Secretary and Operations Manager

Phone

(615) 969-7391

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Crisp Regional Hospital, Inc

  • Skilled Nursing Facility
  • Cordele, GA
  • NPI 1164855755

  Member Of

  NPD member

Locations

Practitioners 6

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

• Nestor Eduardo Almeida, MD

  • Nephrology Physician
  • Cordele, GA
  • NPI 1891089926
  Medicare reassignment Care Compare group NPD
• Judy Lynn Fajardo, AGCANP-BC

  • Acute Care Nurse Practitioner
  • Cordele, GA
  • NPI 1811548597
  Medicare reassignment Care Compare group NPD
• Bethany Lynn Keith, MS, RDN, LD, CNSC

  • Renal Nutrition Registered Dietitian
  • Lawrenceville, GA
  • NPI 1972105070
  Medicare reassignment NPD
• Srilatha Nadipineni, MD

  • Internal Medicine Physician
  • Cordele, GA
  • NPI 1073720496

  Nephrology

  Medicare reassignment NPD
• Francis Gregory Grillo, M.D.

  • Nephrology Physician
  • Hanover, PA
  • NPI 1649376088

  GA

  Medicare reassignment NPD
• Haley D Justus, R.D., L.D.N.

  • Registered Dietitian
  • Hendersonville, NC
  • NPI 1861896672

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1336726215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 AUTUMN SPRINGS CT STE D",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370672847",
            "telephone_number": "615-695-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W 4TH AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153214",
            "telephone_number": "615-695-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CLINIC CORDELE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-26",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "LEPLEY",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "SECRETARY AND OPERATIONS MANAGER",
        "authorized_official_telephone_number": "615-969-7391"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall W Jordan, OD
• Jyoti Karki, FNP
• Mana L Kasongo, MD
• David Kavtaradze, M.D.
• Kelley Granade Kichler, RD, LD, CNSD
• Bianca Kierce, NP
• Emily Selph King, MS, RD, LD
• Keshia King
• Marcy King, FNP
• Amber Khristina Knight

• Nephrology Physician in Cordele, GA
• Providers in Cordele, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.