IMPACT PHYSICIAN GROUP NEPHROLOGY, LLC
NPI 1003704875
Internal Medicine - Nephrology in Lebanon, IN
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
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Impact Physician Group Nephrology, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Impact Physician Group Nephrology, LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Is Impact Physician Group Nephrology, LLC enrolled in Medicare?
Yes. Impact Physician Group Nephrology, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Impact Physician Group Nephrology, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Impact Physician Group Nephrology, LLC, in Family Practice and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Impact Physician Group Nephrology, LLC accept?
Health plans from Anthem Blue Cross and Blue Shield list Impact Physician Group Nephrology, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
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 15 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.
# Impact Physician Group Nephrology, Llc · NPI 1003704875
Nephrology organization in Lebanon, Indiana. Organization record, active in the CMS NPPES registry since June 27, 2025.
## Identity
- **NPI:** 1003704875 (Entity type: Organization)
- **Enumerated:** June 27, 2025
- **Primary specialty:** Internal Medicine - Nephrology · taxonomy 207RN0300X
- **Organization subpart:** No
- **Authorized official:** Paul Miller, CEO
## Practice location
- **Address:** 1585 PERRY WORTH RD, Lebanon, IN 46052-9635
- **Phone:** (765) 482-6391
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (2), Internal Medicine (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 28, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1003704875) · Data from the CMS NPPES public registry.