Provider Demographics
NPI:1063839041
Name:NEPHROCARE TENNESSEE PLLC
Entity Type:Organization
Organization Name:NEPHROCARE TENNESSEE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHUTOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:865-483-7511
Mailing Address - Street 1:200 NEW YORK AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-5225
Mailing Address - Country:US
Mailing Address - Phone:865-483-7511
Mailing Address - Fax:865-483-7959
Practice Address - Street 1:200 NEW YORK AVE STE 330
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-5225
Practice Address - Country:US
Practice Address - Phone:865-483-7511
Practice Address - Fax:865-483-7959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000039067207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3718861Medicaid
TN3718861Medicaid
TNI23717Medicare UPIN