Kidney Care PA

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

25MA08683000 Issued in NJ

Legal business name

KIDNEY CARE PA

Practice address

2130 Millburn Ave
Suite C3
Maplewood, NJ 07040-3725

Phone

(973) 996-2727

Fax

(973) 763-2558

NPI assigned

Mar 4, 2014

Last updated

Apr 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Simon V Segun, MD

Title

MD

Phone

(973) 996-2727

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

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.

• Segun V Simon, MD

  • Nephrology Physician
  • Maplewood, NJ
  • NPI 1194956490
  Medicare reassignment NPD
• Guy Anthony Francis, MD

  • Family Medicine Physician
  • Maplewood, NJ
  • NPI 1376554378
  NPD (past)

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1871918615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 373",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070782152",
            "telephone_number": "973-373-0903",
            "fax_number": "973-373-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVE",
            "address_2": "SUITE C3",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403725",
            "telephone_number": "973-996-2727",
            "fax_number": "973-763-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "SEGUN",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "973-996-2727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA08683000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1194956490",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Katz, LCSW
• Kehunah Health Services, L.L.C
• Julia F Kelly
• Edna Moraa Kennedy
• Linde Kate Kennell
• Nancy C Kiel, D.C.
• King Dave Home Care LLC
• Amanda Renee Kirpitch, MA, RD, CDCES
• Kenzie Kitcharoen, M.D.
• Heather Lynn Knight-Sabio, OTR/L

• Nephrology Physician in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.