Delta Hills Nephrology Associates
Organization Active NPI Nephrology Physician · Greenwood, MS
NPI 1841222437 · NPPES record last updated Apr 23, 2008
Key facts
- NPI
- 1841222437
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nephrology Physician 207RN0300X
- Legal business name
- DELTA HILLS NEPHROLOGY ASSOCIATES
- Practice address
- Delta Hills Nephrology Associates
609 Tallahatchie Street
Greenwood, MS 38930 - Phone
- (662) 453-5208
- Fax
- (662) 453-7367
- NPI assigned
- Jul 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Allison Randall White, M.D.
- Title
- Director
- Phone
- (662) 453-5208
Practitioners 5
-
Kara Austin, NP
-
Elizabeth Whites, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050422000819 | MS | Part B Supplier - Clinic/Group Practice | 0941248579 |
Receives reassigned benefits from 5 practitioners Practice locations: Cleveland, MS; Lexington, MS; Indianola, MS; Grenada, MS; Greenwood, MS |
National Provider Directory
Locations
33 W Monroe St
Grenada, MS 38901
122 E Baker St
Indianola, MS 38751
Phone (662) 335-0183
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician |
207RN0300X | Yes |
Addresses
Primary practice location
Delta Hills Nephrology Associates
609 Tallahatchie Street
Greenwood, MS 38930
Mailing address
609 Tallahatchie St
Greenwood, MS 38930-2005
Phone (662) 453-5208
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09014642 | Medicaid | MS |
Other providers in Greenwood, MS
- Erin Vonshae Davis
- Jasmyne Davis
- Makhiya Chantel Davis
- Shakeyia Brianna Davis
- Misha J Day
- Delta Hills Nephrology Clinics PLLC
- Delta Oncology, Inc.
- Starlette Dent
- Diaper Man LLC
- Divine Hospice and Palliative Care LLC
All providers in Greenwood, MS · Nephrology Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.