NPIMap

Organization Active NPI

Kern Nephrology Medical Group

Doing business as Central Kern Nephrology Medical Group

  • Nephrology Physician
  • Bakersfield, CA
National Provider Identifier
1962454140
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A35716 Issued in CA
Legal business name
KERN NEPHROLOGY MEDICAL GROUP
Doing business as
Central Kern Nephrology Medical Group
Practice address
5030 Office Park Dr
Bakersfield, CA 93309-0612
Phone
(661) 323-2847
Fax
(661) 323-2261
NPI assigned
May 16, 2006
Last updated
May 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Authorized official

Name
Dr. Umamaheswara Rao Varanasi, M.D.
Title
Partner
Phone
(661) 323-2847

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A35716 CA Primary

Addresses

Primary practice location

5030 Office Park Dr
Bakersfield, CA 93309-0612

Mailing address

5030 Office Park Dr
Bakersfield, CA 93309-0612
Phone (661) 323-2847

Other identifiers 1

IdentifierTypeStateIssuer
GR0007980MedicaidCA

Other names 1

  • Central Kern Nephrology Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050812000984 CA Part B Supplier - Clinic/Group Practice 9335179092 Receives reassigned benefits from 8 practitioners
Practice locations: Bakersfield, CA; Porterville, CA; Lindsay, CA; Delano, CA

National Provider Directory

National Provider Directory

Member organizations 1

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

Locations

5030 Office Park Dr
#A
Bakersfield, CA 93309
Phone (661) 323-2847

443 W Morton Ave
#A
Porterville, CA 93257
Phone (559) 788-6340

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1962454140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 OFFICE PARK DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090612",
            "telephone_number": "661-323-2847",
            "fax_number": "661-323-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 OFFICE PARK DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090612",
            "telephone_number": "661-323-2847",
            "fax_number": "661-323-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERN NEPHROLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "VARANASI",
        "authorized_official_first_name": "UMAMAHESWARA",
        "authorized_official_middle_name": "RAO",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "661-323-2847",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A35716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0007980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Kern Nephrology Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Kern Nephrology Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.