NPIMap

Organization Active NPI

Nephrology Associates, LLC

  • Nephrology Physician
  • Evansville, IN
National Provider Identifier
1467403758
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHROLOGY ASSOCIATES, LLC
Practice address
1401 Professional Blvd Ste 101
Evansville, IN 47714-8011
Phone
(812) 491-6419
Fax
(812) 491-6419
NPI assigned
May 12, 2006
Last updated
May 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Authorized official

Name
Ms. Jane L Harris
Title
Credentialing Coordinator
Phone
(812) 491-6419

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

1401 Professional Blvd Ste 101
Evansville, IN 47714-8011

Mailing address

1401 Professional Blvd Ste 101
Evansville, IN 47714-8011
Phone (812) 491-6419

Other identifiers 3

IdentifierTypeStateIssuer
CC9243OtherINRAILROAD MEDICARE
100246190AMedicaidIN
1002461900MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050630000193 KY Part B Supplier - Clinic/Group Practice 4688610637 Receives reassigned benefits from 7 practitioners
Practice locations: Cadiz, KY; Henderson, KY; Kuttawa, KY; Madisonville, KY; Princeton, KY
O20060519000114 IN Part B Supplier - Clinic/Group Practice 4688610637 Receives reassigned benefits from 7 practitioners
Practice locations: Tell City, IN; Washington, IN; Vincennes, IN; Princeton, IN; Paoli, IN; Newburgh, IN; Jasper, IN; Evansville, IN

National Provider Directory

National Provider Directory

Locations

1151 W Buena Vista Rd
Evansville, IN 47710
Phone (812) 401-0140

1401 Professional Blvd
Ste 101
Evansville, IN 47714
Phone (812) 491-6419

2809 Lincoln Ave
Ste 130
Evansville, IN 47714
Phone (812) 297-5780

5401 Vogel Rd
Ste 440
Evansville, IN 47715

953 S Kenmore Dr
Evansville, IN 47714
Phone (812) 491-6419

4311 Highway 261
Ste A
Newburgh, IN 47630
Phone (812) 853-2010

2227 Sherman Dr
Princeton, IN 47670
Phone (812) 385-2906

1602 Main St
Tell City, IN 47586
Phone (812) 547-1140

700 Willow St
Vincennes, IN 47591
Phone (812) 882-0023

2480 US Highway 41 N
Henderson, KY 42420
Phone (270) 823-3875

255 E North St
Madisonville, KY 42431
Phone (270) 821-7824

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1467403758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 PROFESSIONAL BLVD STE 101",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148011",
            "telephone_number": "812-491-6419",
            "fax_number": "812-491-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PROFESSIONAL BLVD STE 101",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148011",
            "telephone_number": "812-491-6419",
            "fax_number": "812-491-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "812-491-6419",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC9243",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100246190A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002461900",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.