Cumberland Kidney Specialist

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

CUMBERLAND KIDNEY SPECIALIST

Practice address

117 N Hickory Ave Ste 200
Cookeville, TN 38501-2424

Phone

(931) 646-0880

Fax

(866) 834-5618

NPI assigned

Mar 6, 2009

Organization subpart

No

Name

Anju Mendiratta, M.D.NPI 1578533105

Title

Physician / Sole MBR

Phone

(931) 646-0880

Organizations listed as members of this organization in the National Provider Directory.

• Dialysis Care Center Crossville LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Crossville, TN
  • NPI 1720431984

  Member Of

  NPD member

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anju Mendiratta, MD

  • Nephrology Physician
  • Cookeville, TN
  • NPI 1578533105

  Single Specialty, TN

  Medicare reassignment Care Compare group NPD Authorized official
• Rebecca Jones, APN

  • Family Nurse Practitioner
  • Cookeville, TN
  • NPI 1578971156

  TN

  Medicare reassignment Care Compare group NPD
• Tracie Adams, FNP-C

  • Primary Care Nurse Practitioner
  • Lafayette, TN
  • NPI 1790357564

  TN

  Medicare reassignment NPD
• Boonphiphop Boonpheng, M.D.

  • Nephrology Physician
  • Cookeville, TN
  • NPI 1659723104

  Nephrology, TN

  Medicare reassignment NPD
• Katelyn Marie Jones, APRN, FNP-C

  • Family Nurse Practitioner
  • Brentwood, TN
  • NPI 1649986035

  TN

  Medicare reassignment NPD
• Kaitlyn Brooke Mashburn, NP

  • Family Nurse Practitioner
  • Cookeville, TN
  • NPI 1427634583

  TN

  Medicare reassignment NPD
• Sharmil Suma Kumaran, M.D.

  • Nephrology Physician
  • Elkins, WV
  • NPI 1780175844

  Nephrology, TN

  Medicare reassignment NPD
• Briana Roberts, PA-C

  • Physician Assistant
  • Knoxville, TN
  • NPI 1013615053

  TN

  Medicare reassignment
• William Flowers, FNP-C

  • Family Nurse Practitioner
  • Jamestown, TN
  • NPI 1962855445
  NPD (past)
• Priscilla Martin, FNP

  • Primary Care Nurse Practitioner
  • Cookeville, TN
  • NPI 1548046857
  NPD (past)
• Tyler Cade York, FNP

  • Family Nurse Practitioner
  • Cookeville, TN
  • NPI 1477471746
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in TN

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18263/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 11, 2022.

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1922248756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 N HICKORY AVE STE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012424",
            "telephone_number": "931-646-0880",
            "fax_number": "931-646-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N HICKORY AVE STE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012424",
            "telephone_number": "931-646-0880",
            "fax_number": "866-834-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND KIDNEY SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-06",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "MENDIRATTA",
        "authorized_official_first_name": "ANJU",
        "authorized_official_title_or_position": "PHYSICIAN / SOLE MBR",
        "authorized_official_telephone_number": "931-646-0880",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TN",
            "license": "040111",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rad Maxey Cuebas, RN
• Rebecca Culver, LMSW
• Cumberland Addiction & Recovery Program, PLLC
• Cumberland Back Pain Clinic PC
• Cumberland Imaging Associates, PC
• Cumberland Neurological and Spinal Surgery
• Cumberland Rehabilitation Services LLC
• Astria Cunningham
• Cheryl A Cunningham, PA-C
• Cura Partners, LLC

• All providers in Cookeville, TN
• Nephrology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.