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BRANSON NEPHROLOGY LLC NPI 1427025212


NPI Information

NPI: 1427025212
Provider Name: BRANSON NEPHROLOGY LLC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 26D1007104

Address:
101 SKAGGS RD
SUITE 302
BRANSON, MO
ZIP 65616
Phone: (417) 334-8288
Get Directions

BRANSON NEPHROLOGY LLC is a nephrology internal medicine in Branson, MO. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. BRANSON NEPHROLOGY LLC NPI is 1427025212. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

101 SKAGGS RD
SUITE 302
BRANSON, MO
ZIP 65616-075
Phone: (417) 334-8288
Fax: (417) 334-6966

The provider's authorized official is John R Martinez .
The authorized official title is President and has the following contact phone number (417) 334-8288.

The CLIA number assigned to this NPI record is 26D1007104 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/1/2006 and was last updated on 12/23/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1170362OTHERMISSOURIBLUE CROSS MISSOURI
2506052000MEDICAIDMISSOURI
31245268051MEDICAIDARKANSAS
4000013780MEDICARE ID-TYPE UNSPECIFIEDMISSOURIMO MEDICARE
5CK7038OTHERMISSOURIRAILROAD MEDICARE
65C851MEDICARE ID-TYPE UNSPECIFIEDARKANSASARK MEDICARE
71154352417MEDICAIDARKANSAS
8149154002MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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