Organization Active NPI

Dyersburg Kidney Clinic, Inc

  • Chronic Disease Hospital
  • Jackson, TN
National Provider Identifier
1821207911
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Chronic Disease HospitalTaxonomy code 281P00000X
Legal business name
DYERSBURG KIDNEY CLINIC, INC
Practice address
16 Murray Guard Drive
Jackson, TN 38305
Phone
(731) 668-4284
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Kandala Ram Chary, M.D.
Title
Medical Director
Phone
(731) 668-6907

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chronic Disease Hospital 281P00000X TN Primary
General Acute Care Hospital 282N00000X MD00000124 TN

Addresses

Primary practice location

16 Murray Guard Drive
Jackson, TN 38305

Mailing address

640C Hwy 51 Bypass
Dyersburg, TN 38024
Phone (731) 668-6907

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1821207911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640C HWY 51 BYPASS",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "38024",
            "telephone_number": "731-668-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MURRAY GUARD DRIVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-668-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYERSBURG KIDNEY CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "CHARY",
        "authorized_official_first_name": "KANDALA",
        "authorized_official_middle_name": "RAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "731-668-6907",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "281P00000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital",
            "state": "TN",
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TN",
            "license": "MD00000124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.