Individual provider Active NPI

John K Endsley, MD

  • Nephrology Physician
  • Clarksville, TN
National Provider Identifier
1417938432
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
23560 Issued in TN
Practice address
311 Landrum Place
Ste 100
Clarksville, TN 37043
Phone
(931) 245-2090
Fax
(931) 245-2091
NPI assigned
Nov 8, 2005
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 23560 TN Primary

Addresses

Primary practice location

311 Landrum Place
Ste 100
Clarksville, TN 37043

Mailing address

311 Landrum Place
Ste 100
Clarksville, TN 37043
Phone (931) 245-2090

Other identifiers 2

IdentifierTypeStateIssuer
3892497MedicaidTN
3892498MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040504001106 TN Practitioner - Nephrology 3779571153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23560TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates, PC Nephrology CurrentSince Jan 1, 2021 Accepting new patients
Baptist Health Deaconess Madisonville Inc Past Accepting new patients

Locations

451 Rossview Rd
Clarksville, TN 37043
Phone (931) 245-2090

854 W James M Campbell Blvd
Ste 101A
Columbia, TN 38401
Phone (931) 388-3209

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1417938432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 LANDRUM PLACE",
            "address_2": "STE 100",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37043",
            "telephone_number": "931-245-2090",
            "fax_number": "931-245-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 LANDRUM PLACE",
            "address_2": "STE 100",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37043",
            "telephone_number": "931-245-2090",
            "fax_number": "931-245-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDSLEY",
        "first_name": "JOHN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "23560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3892497",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3892498",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.