Kidney Associates DFW LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

KIDNEY ASSOCIATES DFW LLC

Practice address

2022 W Northwest Hwy Ste 100
Grapevine, TX 76051-6953

Phone

(817) 421-0380

Fax

(817) 421-0986

NPI assigned

Feb 9, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Sudharani Dikkala, MDNPI 1275798019

Title

Nephrology

Phone

(817) 886-5966

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Sudharani Dikkala, M.D.

  • Nephrology Physician
  • Fort Worth, TX
  • NPI 1275798019
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1720732506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 HELMSLEY PL",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926196",
            "telephone_number": "817-886-5966",
            "fax_number": "817-934-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 W NORTHWEST HWY STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760516953",
            "telephone_number": "817-421-0380",
            "fax_number": "817-421-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY ASSOCIATES DFW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "DIKKALA",
        "authorized_official_first_name": "SUDHARANI",
        "authorized_official_title_or_position": "NEPHROLOGY",
        "authorized_official_telephone_number": "817-886-5966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amir M Khan, M.D.
• Sarah Khan, MD
• Imran Shuja Khawaja, M.D.
• Michael Saul Khazzam, MD
• Zubin G Khubchandani, M.D.
• Andrew H Kilgus, MD
• Joseph Richard Kilianski Jr., MD
• Ashley Kim
• Kimberly S. Marshall, M.D., P.a.
• Kimberly Salinas Marshall MD, PA

• Nephrology Physician in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.