Kidney Care Clinic Pllc - Medicare in Cookeville, TN

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Kidney Care Clinic Pllc is a medicare enrolled "Internal Medicine - Nephrology" provider in Cookeville, Tennessee. Their current practice location is 427 N Willow Ave Ste C, Cookeville, Tennessee. You can reach out to their office (for appointments etc.) via phone at (931) 650-0076.

Kidney Care Clinic Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Kidney Care Clinic Pllc is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1932779170.

Contact Information

Kidney Care Clinic Pllc
427 N Willow Ave Ste C,
Cookeville, TN 38501-2354
(931) 650-0076
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameKidney Care Clinic Pllc
TypeFacility
SpecialityInternal Medicine - Nephrology
Location427 N Willow Ave Ste C, Cookeville, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1932779170
  • Provider Enumeration Date: 06/29/2021
  • Last Update Date: 01/08/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 6406244599
  • Enrollment ID: O20211021002535

Medical Identifiers

Medical identifiers for Kidney Care Clinic Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1932779170NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
133VN1004XDietitian, Registered - Nutrition, Pediatric (* (Not Available))Secondary
363LF0000XNurse Practitioner - Family (* (Not Available))Secondary
207RN0300XInternal Medicine - Nephrology (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Kidney Care Clinic Pllc acts as a billing entity for following providers:
Provider NameTeresa Mantaring Patterson
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1265494488
PECOS PAC ID: 7719873611
Enrollment ID: I20040226000826
Provider NameElizabeth A Walker
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1790835601
PECOS PAC ID: 0941394001
Enrollment ID: I20070919000983
Provider NameZaid Brifkani
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1457516163
PECOS PAC ID: 6507036092
Enrollment ID: I20110818000526
Provider NameShauna Elaine Samuel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053898163
PECOS PAC ID: 4183976657
Enrollment ID: I20181010003221
Provider NameNoor Brifkani
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1518453877
PECOS PAC ID: 7315343647
Enrollment ID: I20210910002037
Provider NameTaylor Adell Russell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801560941
PECOS PAC ID: 3072910843
Enrollment ID: I20210921001874
Provider NameRohan Kataria
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1821587353
PECOS PAC ID: 8527319334
Enrollment ID: I20230419003090
Provider NameGabino Manuel Maza Rodas
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1710484241
PECOS PAC ID: 8527316892
Enrollment ID: I20230424002389
Provider NameStephanie Ann Legin
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1124448949
PECOS PAC ID: 9234595430
Enrollment ID: I20230512002240
Provider NameLeanna Victoria Ritchie
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1760047971
PECOS PAC ID: 5890022198
Enrollment ID: I20250312003800

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kidney Care Clinic Pllc is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kidney Care Clinic Pllc
427 N Willow Ave Ste C,
Cookeville, TN 38501-2354

Ph: (931) 650-0076		Kidney Care Clinic Pllc
427 N Willow Ave Ste C,
Cookeville, TN 38501-2354

Ph: (931) 650-0076

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.