Valley Kidney Specialists, PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD021858E Issued in PA

Legal business name

VALLEY KIDNEY SPECIALISTS, PC

Practice address

693 Port Carbon Saint Clair Hwy
Pottsville, PA 17901-8604

Phone

(570) 429-1432

Fax

(570) 429-1019

NPI assigned

Feb 3, 2017

Organization subpart

No

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

Authorized official

Name

Ravindra Bollu, M.D.

Title

President

Phone

(610) 432-4529

Specialties & licenses 2

Addresses

Other names 1

• Pottsville Internists & Valley Kidney Specialists Doing business as

Tax ID family

Valley Kidney Specs PC2 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.

• Valley Kidney Specialists, PC

  • Ambulatory Surgical Clinic/Center
  • Bethlehem, PA
  • NPI 1558808287
  NPD tax ID

Locations

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486339200000",
    "number": "1780122366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD",
            "address_2": "SUITE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036367",
            "telephone_number": "610-432-4529",
            "fax_number": "610-432-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "693 PORT CARBON SAINT CLAIR HWY",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179018604",
            "telephone_number": "570-429-1432",
            "fax_number": "570-429-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY KIDNEY SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-03",
        "last_updated": "2017-02-06",
        "status": "A",
        "authorized_official_last_name": "BOLLU",
        "authorized_official_first_name": "RAVINDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-432-4529",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD021858E",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD044932E",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pottsville Internists & Valley Kidney Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• US Sleep Physicians Inc
• Usv Optical Inc.
• Beth A Vanselous
• Rebecca Verderame, MS OTR/L
• Daria Verdonik, PA-C
• Susan Vernitsky, CRNP
• Karen L Vigoda, MSW

• Nephrology Physician in Pottsville, PA
• Providers in Pottsville, PA by specialty
• Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; 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.