Coordinated Kidney Care Group, Inc.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD045564E Issued in PA

Legal business name

COORDINATED KIDNEY CARE GROUP, INC.

Practice address

1 Nolte Dr BLDG 700
Kittanning, PA 16201-7111

Phone

(724) 548-1395

NPI assigned

Oct 5, 2007

Organization subpart

No

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

Authorized official

Name

C. Ross Betts, MD

Title

Physician

Phone

(724) 548-1395

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Locations

Practitioners 15

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

• Charles R Betts, MD

  • Nephrology Physician
  • Kittanning, PA
  • NPI 1124014634
  Medicare reassignment Care Compare group NPD
• David Michael Brooker, DO

  • Internal Medicine Physician
  • Clarion, PA
  • NPI 1689133787
  Medicare reassignment Care Compare group NPD
• David R Brooker, M.D.

  • Nephrology Physician
  • Cranberry, PA
  • NPI 1649214552
  Medicare reassignment Care Compare group NPD
• Lori Griffith, CRNP

  • Nurse Practitioner
  • Butler, PA
  • NPI 1609171792
  Medicare reassignment Care Compare group NPD
• Pamela Kapustik, RD LDN

  • Registered Dietitian
  • Butler, PA
  • NPI 1992387708
  Medicare reassignment Care Compare group NPD
• Rajil Mehta

  • Nephrology Physician
  • Kittanning, PA
  • NPI 1376598870
  Medicare reassignment Care Compare group NPD
• Amith Roy Shamir, M.D.

  • Nephrology Physician
  • Butler, PA
  • NPI 1275883415
  Medicare reassignment Care Compare group NPD
• Smitha Thomas-Mathew, M.D

  • Nephrology Physician
  • Kittanning, PA
  • NPI 1881824613

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Ashley Clark, MSN

  • Family Nurse Practitioner
  • Clarion, PA
  • NPI 1245781285
  Medicare reassignment NPD
• Christine M Fortuna, OTR/L

  • Occupational Therapist
  • Carnegie, PA
  • NPI 1780298935

  Single Specialty

  Medicare reassignment NPD
• Kenneth Adam Hile, CRNP

  • Family Nurse Practitioner
  • Kittanning, PA
  • NPI 1841065232
  Medicare reassignment NPD
• Stephenie C. Swisher, CRNP

  • Nurse Practitioner
  • Kittanning, PA
  • NPI 1144346065
  Medicare reassignment NPD

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1407044308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1001",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162015001",
            "telephone_number": "724-548-1395",
            "fax_number": "724-548-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NOLTE DR BLDG 700",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017111",
            "telephone_number": "724-548-1395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Woody Dr",
            "address_purpose": "LOCATION",
            "city": "Butler",
            "state": "PA",
            "postal_code": "160017603",
            "country_code": "US",
            "telephone_number": "724-287-1000",
            "fax_number": "724-548-1396",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6945 US 322 Unit 508",
            "address_purpose": "LOCATION",
            "city": "Cranberry",
            "state": "PA",
            "postal_code": "163193126",
            "country_code": "US",
            "telephone_number": "814-678-1177",
            "fax_number": "814-678-3377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29 E North St Ste 203",
            "address_purpose": "LOCATION",
            "city": "New Castle",
            "state": "PA",
            "postal_code": "161013741",
            "country_code": "US",
            "telephone_number": "724-856-7055",
            "fax_number": "724-856-7034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22631 Route 68 Ste 450B",
            "address_purpose": "LOCATION",
            "city": "Clarion",
            "state": "PA",
            "postal_code": "162144076",
            "country_code": "US",
            "telephone_number": "814-227-2940",
            "fax_number": "814-678-3377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "218 Oak St Unit 2",
            "address_purpose": "LOCATION",
            "city": "Grove City",
            "state": "PA",
            "postal_code": "161271022",
            "country_code": "US",
            "telephone_number": "724-264-4700",
            "fax_number": "814-678-3377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COORDINATED KIDNEY CARE GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "BETTS",
        "authorized_official_first_name": "C. ROSS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "724-548-1395",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD045564E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Marie Cochran
• Maria Alexandra Cohen, M.D.
• Cole Vision Corporation
• Nicole R Coleman-Hammett
• Curt P Conry, M.D.
• Diego R Cordoba, M.D.
• County of Armstrong
• Dallas Joseph Cousins, RN,NP
• Madison M Coyle, RN
• David Cribbs, RN, BSN

• Nephrology Physician in Kittanning, PA
• Providers in Kittanning, PA by specialty
• Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.