NPIMap

Organization Active NPI

North Florida Nephrology Associates

  • Nephrology Physician
  • Tallahassee, FL
National Provider Identifier
1720089071
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NORTH FLORIDA NEPHROLOGY ASSOCIATES
Practice address
2617 Mitcham Dr Ste 102
Tallahassee, FL 32308-5479
Phone
(850) 878-1171
Fax
(850) 942-1291
NPI assigned
Aug 9, 2005
Last updated
Aug 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Authorized official

Name
Diane L Walker
Title
Office Manager
Phone
(850) 878-1171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

2617 Mitcham Dr Ste 102
Tallahassee, FL 32308-5479

Mailing address

2617 Mitcham Dr Ste 102
Tallahassee, FL 32308-5479
Phone (850) 878-1171

Other identifiers 1

IdentifierTypeStateIssuer
060754100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clinical@nfna.directbygreenway.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070910001007 FL Part B Supplier - Clinic/Group Practice 9436242211 Receives reassigned benefits from 11 practitioners
Practice locations: Tallahassee, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0270162North Florida Nephrology Associates2617 Mitcham Drive Suite 102, Tallahassee, FL 32308Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: clinical@nfna.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72257

Practitioners & affiliated clinicians

Practitioners 12

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": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1720089071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 MITCHAM DR STE 102",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085479",
            "telephone_number": "850-878-1171",
            "fax_number": "850-942-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 MITCHAM DR STE 102",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085479",
            "telephone_number": "850-878-1171",
            "fax_number": "850-942-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA NEPHROLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-878-1171"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060754100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clinical@nfna.directbygreenway.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2617 Mitcham Dr Ste 102",
            "city": "Tallahassee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "323085479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.