NPIMap

Organization Active NPI

Kidney Dialysis & Transplant Group Incorporated

  • Nephrology Physician
  • Bridgeport, WV
National Provider Identifier
1932473055
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
21364 Issued in WV
Legal business name
KIDNEY DIALYSIS & TRANSPLANT GROUP INCORPORATED
Practice address
166 Thompson Dr
Bridgeport, WV 26330-1644
Phone
(304) 842-6001
NPI assigned
Mar 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Authorized official

Name
Nabil Guirguis
Title
President
Phone
(304) 842-6001

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1005X 20 WV
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 21364 WV Primary

Addresses

Primary practice location

166 Thompson Dr
Bridgeport, WV 26330-1644

Mailing address

166 Thompson Dr
Bridgeport, WV 26330-1644

National Provider Directory

National Provider Directory

Locations

166 Thompson Dr
Ste B
Bridgeport, WV 26330
Phone (304) 842-5668

166 Thompson Dr
#B
Bridgeport, WV 26330
Phone (304) 842-5668

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1932473055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 THOMPSON DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 THOMPSON DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301644",
            "telephone_number": "304-842-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY DIALYSIS & TRANSPLANT GROUP INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "GUIRGUIS",
        "authorized_official_first_name": "NABIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-842-6001"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "WV",
            "license": "20",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "WV",
            "license": "21364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.