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VICKSBURG NEPHROLOGY LLC
NPI 1013337658
Internal Medicine - Nephrology in Vicksburg, MS

Active since April 22, 2014
104 MCAULEY DR, VICKSBURG, MS 39183(601) 738-5549(601) 630-9120 Get Directions Write a Review

NPPES record last updated: April 22, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Vicksburg Nephrology Llc NPPES

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

VICKSBURG NEPHROLOGY LLC (NPI 1013337658) is a healthcare organization registered as a nephrology in Vicksburg, Mississippi and active in the NPI registry since April 2014. The organization lists Michael L Davis, Owner, as its authorized official.

NPPES Registry Identity

NPI1013337658
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameVICKSBURG NEPHROLOGY LLC
Location Address104 MCAULEY DRVicksburg, MS 39183-2825
Mailing AddressPo Box 820663Vicksburg, MS 39182-0663 · (601) 738-5549 · Fax (601) 630-9120
Phone(601) 738-5549
Fax(601) 630-9120
Organization SubpartNo
Authorized OfficialMichael L DavisOwner · (601) 738-5549
Enumeration DateApril 22, 2014
✔ NPI 1013337658 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.
104 MCAULEY DR, Vicksburg, MS 39183
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Group Practice 1

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Other Providers at the Same Location NPPES 10

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

STANLEY R EASTERLING MD
Family Medicine
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 638-7271
SUZANNE CHANNELL ATC, LAT, MBA
Specialist/Technologist (Athletic Trainer)
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 883-6309
DIABETIC SHOE SOURCE
Durable Medical Equipment & Medical Supplies
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 883-3342
STEPHANIE FAY PHELAN
Durable Medical Equipment & Medical Supplies
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 883-3342
VICKSBURG ALLERGY AND ASTHMA
Allergy & Immunology
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 636-0097
FRANCINE F JOHNSON RD
Dietitian, Registered
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 619-3610
DANIEL P EDNEY MD
Internal Medicine
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 638-7271
WILLIAM H WOOTEN MD
Internal Medicine
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 638-7271

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 Vicksburg Nephrology LLC's NPI number?

The NPI number for Vicksburg Nephrology LLC is 1013337658. It was assigned to this organization in the NPPES registry on April 22, 2014.

Where is Vicksburg Nephrology LLC located?

Vicksburg Nephrology LLC is located at 104 Mcauley Dr, Vicksburg, MS 39183. The listed phone number is (601) 738-5549.

What is Vicksburg Nephrology LLC's specialty?

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

What insurance does Vicksburg Nephrology LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Vicksburg 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 Vicksburg Nephrology LLC was last updated on April 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.