Madison Kidney Clinic

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MADISON KIDNEY CLINIC

Practice address

16 Murray Guard Dr
Jackson, TN 38305-3750

Phone

(731) 668-4337

Fax

(731) 661-0124

NPI assigned

Dec 4, 2008

Last updated

Dec 4, 2008By 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

Ms. Teresa Lynn Collis

Title

Office Manager

Phone

(731) 668-4337

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1942445994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MURRAY GUARD DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053750",
            "telephone_number": "731-668-4337",
            "fax_number": "731-661-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MURRAY GUARD DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053750",
            "telephone_number": "731-668-4337",
            "fax_number": "731-661-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON KIDNEY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "COLLIS",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "731-668-4337",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Clinic Corp
• Madison Clinic Corp Dba Jackson Pediatric Center
• Madison Fam Walk in Clinic Limited
• Madison Family Practice
• Madison Haywood County Developmental Services, Inc
• Madison Physician Group Inc
• Magnolia Care Services, LLC (MCS)
• Natasha C Mahajan, MD
• Kamran Mahalati, M.D.
• Morgan Hope Mahan, CPNP-PC

• Specialist in Jackson, TN
• Providers in Jackson, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.