Kidney Disease and Hypertension Specialists LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

2006018918 Issued in MO

Legal business name

KIDNEY DISEASE AND HYPERTENSION SPECIALISTS LLC

Practice address

2620 N Westwood Blvd
Poplar Bluff, MO 63901-3396

Phone

(573) 785-7721

NPI assigned

Dec 16, 2008

Organization subpart

No

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

Authorized official

Name

Fayyaz H Sagarwala, MD

Title

Member

Phone

(573) 785-5444

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229385600000",
    "number": "1447496708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2628 BARRON RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011916",
            "telephone_number": "573-785-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013396",
            "telephone_number": "573-785-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY DISEASE AND HYPERTENSION SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-16",
        "last_updated": "2008-12-16",
        "status": "A",
        "authorized_official_last_name": "SAGARWALA",
        "authorized_official_first_name": "FAYYAZ",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "573-785-5444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MO",
            "license": "2006018918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaqoob Khan, MD
• Lynn T Khanuja, MA, LPC, OTR/L
• Ravdeep S Khanuja, M.D.
• Sarah Beth Khoan, CRADC, CS #1909
• Isbah Khurram, MD
• Samara Kilgore
• Darrel Killian
• Jeffrey E Killian, BS
• Jill Kathleen Kimball
• Kimberly a Schisler D O P C

• Medical Specialty Clinic/Center in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Medical Specialty Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; 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.