NPIMap

Organization Active NPI

Kidney Specialists of Paducah PLLC

  • Nephrology Physician
  • Paducah, KY
National Provider Identifier
1740765957
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
KIDNEY SPECIALISTS OF PADUCAH PLLC
Practice address
1532 Lone Oak Rd Ste 315
Paducah, KY 42003-7942
Phone
(270) 538-5880
Fax
(270) 538-5870
NPI assigned
Oct 3, 2018
Last updated
Dec 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Authorized official

Name
Dr. Shaukat Ali, MDNPI 1700956844
Title
Member
Phone
(270) 538-5880

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Adult Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SA2200X

Addresses

Primary practice location

1532 Lone Oak Rd Ste 315
Paducah, KY 42003-7942

Mailing address

1532 Lone Oak Rd Ste 315
Paducah, KY 42003-7942
Phone (270) 538-5880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IL, TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20181129003134 KY Part B Supplier - Clinic/Group Practice 1557605649 Receives reassigned benefits from 8 practitioners
Practice locations: Cadiz, KY; Hopkinsville, KY; Murray, KY; Paducah, KY
O20190213002893 IL Part B Supplier - Clinic/Group Practice 1557605649 Receives reassigned benefits from 5 practitioners
Practice locations: Metropolis, IL
O20190319002805 TN Part B Supplier - Clinic/Group Practice 1557605649 Receives reassigned benefits from 5 practitioners
Practice locations: Parist, TN

National Provider Directory

National Provider Directory

Locations

20 Hospital Dr
Metropolis, IL 62960
Phone (618) 524-3046

2487 Main St
Cadiz, KY 42211

1215 Johnson Blvd
Murray, KY 42071
Phone (270) 992-5000

300 S 8th St
Ste 282
Murray, KY 42071

123 E Wood St
Ste 400
Paris, TN 38242

1323 E Wood St
Ste 400
Paris, TN 38242

57 Commerce St
Paris, TN 38242
Phone (731) 642-7998

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1740765957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 LONE OAK RD STE 315",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037942",
            "telephone_number": "270-538-5880",
            "fax_number": "270-538-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 LONE OAK RD STE 315",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037942",
            "telephone_number": "270-538-5880",
            "fax_number": "270-538-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY SPECIALISTS OF PADUCAH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "SHAUKAT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "270-538-5880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.