NPIMap

Organization Active NPI

Mittal Kidney and Dialysis

  • Adult Health Clinical Nurse Specialist
  • Cordova, TN
National Provider Identifier
1750835724
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
21398 Issued in TN
Legal business name
MITTAL KIDNEY AND DIALYSIS
Practice address
300 S Walnut Bend Rd
Ste 12
Cordova, TN 38018-7293
Phone
(901) 767-0101
Fax
(901) 767-0304
NPI assigned
Aug 8, 2016
Last updated
Aug 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Authorized official

Name
Dr. Sanjeev Kumar Mittal, MDNPI 1689603102
Title
Owner
Phone
(901) 767-0101

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
Adult Health Clinical Nurse Specialist 364SA2200X 21398 TN Primary

Addresses

Primary practice location

300 S Walnut Bend Rd
Ste 12
Cordova, TN 38018-7293

Mailing address

300 S Walnut Bend Rd
Ste 12
Cordova, TN 38018-7293
Phone (901) 767-0101

National Provider Directory

National Provider Directory
Tax ID family
Mittal Kidney and Dialysis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 S Walnut Bend Rd
Ste 12
Cordova, TN 38018
Phone (901) 767-0101

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470614400000",
    "number": "1750835724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S WALNUT BEND RD",
            "address_2": "STE 12",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187293",
            "telephone_number": "901-767-0101",
            "fax_number": "901-767-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S WALNUT BEND RD",
            "address_2": "STE 12",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187293",
            "telephone_number": "901-767-0101",
            "fax_number": "901-767-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITTAL KIDNEY AND DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-08",
        "status": "A",
        "authorized_official_last_name": "MITTAL",
        "authorized_official_first_name": "SANJEEV",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-767-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TN",
            "license": "21398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.