NPIMap

Organization Active NPI

Ohio Valley Nephrology Associates PSC

  • Specialist
  • Owensboro, KY
National Provider Identifier
1952498347
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
OHIO VALLEY NEPHROLOGY ASSOCIATES PSC
Practice address
1930 E Parrish Ave
Owensboro, KY 42303-1443
Phone
(270) 689-1919
Fax
(270) 689-1990
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Authorized official

Name
Mr. Mahendra C Maru, MDNPI 1891792818
Title
President
Phone
(270) 689-1919

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1930 E Parrish Ave
Owensboro, KY 42303-1443

Mailing address

1930 E Parrish Ave
Owensboro, KY 42303-1443
Phone (270) 689-1919

Other identifiers 3

IdentifierTypeStateIssuer
65941023MedicaidKY
204443900OtherKYFEDERAL BLACK LUNG
CJ7612OtherKYMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050927000287 KY Part B Supplier - Clinic/Group Practice 7416981675 Receives reassigned benefits from 7 practitioners
Practice locations: Central City, KY; Owensboro, KY
O20070425000033 IN Part B Supplier - Clinic/Group Practice 7416981675 Receives reassigned benefits from 5 practitioners
Practice locations: Tell City, IN

National Provider Directory

National Provider Directory
Tax ID family
Ohio Valley Nephrology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

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": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499817600000",
    "number": "1952498347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 E PARRISH AVE",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031443",
            "telephone_number": "270-689-1919",
            "fax_number": "270-689-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 E PARRISH AVE",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031443",
            "telephone_number": "270-689-1919",
            "fax_number": "270-689-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO VALLEY NEPHROLOGY ASSOCIATES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2017-07-12",
        "status": "A",
        "authorized_official_last_name": "MARU",
        "authorized_official_first_name": "MAHENDRA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-689-1919",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65941023",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "204443900",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CJ7612",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.