NPIMap

Organization Active NPI

Florida Kidney Physicians, LLC

  • Nephrology Physician
  • Jacksonville, FL
National Provider Identifier
1770155830
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
FLORIDA KIDNEY PHYSICIANS, LLC
Practice address
2585 Herschel St
Jacksonville, FL 32204-4557
Phone
(904) 388-2678
Fax
(904) 388-6776
NPI assigned
Jul 16, 2021
Organization subpart
Yes
Parent organization
FLORIDA KIDNEY PHYSICIANS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Authorized official

Name
Maria Elena Rivera
Title
Credentialing Supervisor
Phone
(480) 610-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

2585 Herschel St
Jacksonville, FL 32204-4557

Mailing address

12662 Telecom Dr
Temple Terrace, FL 33637-0935
Phone (813) 910-0030

Other practice location 1

7200 Normandy Blvd Ste 20
Jacksonville, FL 32205-6271
Phone (904) 388-2678

Other practice location 2

1201 Monument Rd Ste 301
Jacksonville, FL 32225-6494
Phone (904) 388-2678

Other practice location 3

11236 Baptist Health Dr
Jacksonville, FL 32218-2980
Phone (904) 388-2678

Other practice location 4

905 Beach Blvd Ste B
Jacksonville, FL 32250-4303
Phone (904) 388-2678

Other practice location 5

8245 Bayberry Rd
Jacksonville, FL 32256-7432
Phone (904) 388-2678

Other practice location 6

5730 Bowden Rd
Suite 110
Bowden, FL 33216
Phone (904) 388-2678

National Provider Directory

National Provider Directory
Tax ID family
Florida Kidney Physicians LLC12 organizations share this tax ID, including this one
Part of
Florida Kidney Physicians LLC

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626393600000",
    "number": "1770155830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12662 TELECOM DR",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370935",
            "telephone_number": "813-910-0030",
            "fax_number": "813-971-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 HERSCHEL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044557",
            "telephone_number": "904-388-2678",
            "fax_number": "904-388-6776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Normandy Blvd Ste 20",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322056271",
            "country_code": "US",
            "telephone_number": "904-388-2678",
            "fax_number": "904-388-6776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Monument Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322256494",
            "country_code": "US",
            "telephone_number": "904-388-2678",
            "fax_number": "904-388-6776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11236 Baptist Health Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322182980",
            "country_code": "US",
            "telephone_number": "904-388-2678",
            "fax_number": "904-388-6776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 Beach Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322504303",
            "country_code": "US",
            "telephone_number": "904-388-2678",
            "fax_number": "904-388-6776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8245 Bayberry Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322567432",
            "country_code": "US",
            "telephone_number": "904-388-2678",
            "fax_number": "904-388-6776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5730 Bowden Rd",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Bowden",
            "state": "FL",
            "postal_code": "33216",
            "country_code": "US",
            "telephone_number": "904-388-2678",
            "fax_number": "904-388-6776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FLORIDA KIDNEY PHYSICIANS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA KIDNEY PHYSICIANS, LLC",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "ELENA",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "480-610-6100"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.