KIDNEY FOCUSED CARE, LLC NPI 1003418997

Nurse Practitioner (Primary Care) in Jackson, MS

NPI 1003418997 Organization Nurse Practitioner Primary Care CLIA Number 25D2204154 CLIA Certificate of Waiver

About KIDNEY FOCUSED CARE, LLC

Kidney Focused Care, Llc is a provider established in Jackson, Mississippi specializing in nurse practitioner (primary care) . The NPI number of Kidney Focused Care, Llc is 1003418997 and was assigned on November 2020. The practitioner's primary taxonomy code is 363LP2300X. The provider is registered as an organization and their NPI record was last updated April 2021. Kidney Focused Care, Llc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Ms. Jacqueline Diane Boyd Nurse Practitioner (Owner)

A nurse practitioner (NP) like Kidney Focused Care, Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

The CLIA number of Kidney Focused Care, Llc is 25D2204154 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Kidney Focused Care, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1003418997

Provider NameKIDNEY FOCUSED CARE, LLC
Provider Location Address2633 RIDGEWOOD RD STE 105 JACKSON, MS 39216
Provider Mailing Address702 PECAN CT BRANDON, MS 39042
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date11-15-2020
Last Update Date04-22-2021


Primary Taxonomy

Taxonomy Code363LP2300X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationPrimary Care

Business Address

KIDNEY FOCUSED CARE, LLC
2633 RIDGEWOOD RD STE 105
JACKSON, MS
ZIP 39216
Phone: (601) 665-4429
Fax: (601) 665-4429

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Mailing Address

KIDNEY FOCUSED CARE, LLC
702 PECAN CT
BRANDON, MS
ZIP 39042
Phone: (662) 719-9120
Fax: (601) 665-4429



Authorized Official

Authorized Official NameMS. JACQUELINE DIANE BOYD NURSE PRACTITIONER
Authorized Official TitleOWNER
Authorized Official Phone(601) 665-4429

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003418997 is:

CLIA Number25D2204154
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNo

Taxonomy Description: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.