NPIMap

Organization Active NPI

Comprehensive Kidney Disease Center, LLC

  • Nephrology Physician
  • Huntsville, AL
National Provider Identifier
1649574286
Registry record updated Feb 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25611 Issued in AL
Legal business name
COMPREHENSIVE KIDNEY DISEASE CENTER, LLC
Practice address
333 Whitesport Dr SW
Suite 205
Huntsville, AL 35801-6454
Phone
(256) 489-3007
Fax
(256) 489-3045
NPI assigned
Dec 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2011

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

Authorized official

Name
Dr. Amish B Shah, M.D.
Title
Manager
Phone
(256) 489-3007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 25611 AL Primary

Addresses

Primary practice location

333 Whitesport Dr SW
Suite 205
Huntsville, AL 35801-6454

Mailing address

333 Whitesport Dr SW
Suite 205
Huntsville, AL 35801-6454
Phone (256) 489-3007

Other identifiers 1

IdentifierTypeStateIssuer
051519633SHAOtherMEDICARE ID TYPE UNSPECIFIED

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1292976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296864000000",
    "number": "1649574286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 WHITESPORT DR SW",
            "address_2": "SUITE 205",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016454",
            "telephone_number": "256-489-3007",
            "fax_number": "256-489-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 WHITESPORT DR SW",
            "address_2": "SUITE 205",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016454",
            "telephone_number": "256-489-3007",
            "fax_number": "256-489-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE KIDNEY DISEASE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-22",
        "last_updated": "2011-02-05",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "AMISH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "256-489-3007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "25611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECIFIED",
            "identifier": "051519633SHA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2011; 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.