1. Home
  2. Directory
  3. Indiana
  4. Lebanon
  5. Internal Medicine
  6. NPI Profile

IMPACT PHYSICIAN GROUP NEPHROLOGY, LLC
NPI 1003704875
Internal Medicine - Nephrology in Lebanon, IN

Active since June 27, 2025
1585 PERRY WORTH RD, LEBANON, IN 46052(765) 482-6391 Get Directions Write a Review

NPPES record last updated: July 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Impact Physician Group Nephrology, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMPACT PHYSICIAN GROUP NEPHROLOGY, LLC (NPI 1003704875) is a healthcare organization registered as a nephrology in Lebanon, Indiana and active in the NPI registry since June 2025. The organization lists Paul Miller, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003704875
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameIMPACT PHYSICIAN GROUP NEPHROLOGY, LLC
Location Address1585 PERRY WORTH RDLebanon, IN 46052-9635
Mailing Address21 Eastbrook Bnd Ste 218Peachtree City, GA 30269-1546 · (678) 967-5599 · Fax (678) 603-9843
Phone(765) 482-6391
Organization SubpartNo
Authorized OfficialPaul MillerCeo · (678) 699-4977
Enumeration DateJune 27, 2025
Last NPPES UpdateJuly 28, 2025
NPPES CertifiedJuly 28, 2025
✔ NPI 1003704875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
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.
1585 PERRY WORTH RD, Lebanon, IN 46052
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADEYOOLA ALAO OTD, OTR/L
Occupational Therapist
1585 PERRY WORTH RD
LEBANON, IN 46052
Boone County (765) 482-6391
RENPRO INDIANA LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
1585 PERRY WORTH RD
LEBANON, IN 46052
Boone County (847) 443-2000
WATERS OF LEBANON LLC
Skilled Nursing Facility
1585 PERRY WORTH RD
LEBANON, IN 46052
Boone County (765) 482-6391
HICKORY CREEK HEALTHCARE FOUNDATION, INC.
Skilled Nursing Facility
1585 PERRY WORTH RD
LEBANON, IN 46052
Boone County (765) 482-6391
MRS. JESSICA MARIE JUNE M.A., CCC-SLP
Speech-Language Pathologist
1585 PERRY WORTH RD
LEBANON, IN 46052
Boone County (765) 482-6391

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Impact Physician Group Nephrology, LLC's NPI number?

The NPI number for Impact Physician Group Nephrology, LLC is 1003704875. It was assigned to this organization in the NPPES registry on June 27, 2025.

Where is Impact Physician Group Nephrology, LLC located?

Impact Physician Group Nephrology, LLC is located at 1585 Perry Worth Rd, Lebanon, IN 46052. The listed phone number is (765) 482-6391.

What is Impact Physician Group Nephrology, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

When was this NPI record last updated?

The NPPES record for Impact Physician Group Nephrology, LLC was last updated on July 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.