NPIMap

Organization Active NPI

Kidney Center of Missionary Ridge, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chattanooga, TN
National Provider Identifier
1679828255
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
KIDNEY CENTER OF MISSIONARY RIDGE, LLC
Practice address
3810 Brainerd Rd
Chattanooga, TN 37411-3729
Phone
(423) 486-9510
Fax
(423) 486-9512
NPI assigned
Jul 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Authorized official

Name
Nathan Chamberlain, M.D.NPI 1134126246
Title
Administrator
Phone
(423) 468-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

3810 Brainerd Rd
Chattanooga, TN 37411-3729

Mailing address

3810 Brainerd Rd
Chattanooga, TN 37411-3729
Phone (423) 486-9510

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": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389916800000",
    "number": "1679828255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 BRAINERD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113729",
            "telephone_number": "423-486-9510",
            "fax_number": "423-486-9512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 BRAINERD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113729",
            "telephone_number": "423-486-9510",
            "fax_number": "423-486-9512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CENTER OF MISSIONARY RIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2014-01-17",
        "status": "A",
        "authorized_official_last_name": "CHAMBERLAIN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-468-1000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; 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.