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DIVERSIFIED RENAL GROUP LLC
NPI 1184792038
Internal Medicine - Nephrology in Jackson, MS

Active since November 30, 2006
5903 RIDGEWOOD RD, STE 340, JACKSON, MS 39211(601) 899-3340(601) 899-3343 Get Directions Write a Review

NPPES record last updated: April 25, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Diversified Renal Group Llc NPPES

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

DIVERSIFIED RENAL GROUP LLC (NPI 1184792038) is a healthcare organization registered as a nephrology in Jackson, Mississippi and active in the NPI registry since November 2006. The organization lists Gary M Davis, Member, as its authorized official.

NPPES Registry Identity

NPI1184792038
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameDIVERSIFIED RENAL GROUP LLC
Location Address5903 RIDGEWOOD RD, STE 340Jackson, MS 39211
Mailing AddressPo Box 2057Ridgeland, MS 39158 · (601) 899-3340 · Fax (601) 899-3343
Phone(601) 899-3340
Fax(601) 899-3343
Organization SubpartNo
Authorized OfficialGary M DavisMember · (601) 899-3340
Enumeration DateNovember 30, 2006
Last NPPES UpdateApril 25, 2008
✔ NPI 1184792038 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.

5903 RIDGEWOOD RD, Jackson, MS 39211
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Other Identifiers 2

Medicaid09014813MS
Medicare PINC02385MS

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 20

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

RANEY WATTERS SLP
Speech-Language Pathologist
5903 RIDGEWOOD RD
JACKSON, MS 39211
Hinds County (601) 899-3800
MRS. AMBER NICOLE WHITEHORN PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
5903 RIDGEWOOD RD
JACKSON, MS 39211
Hinds County (601) 984-4820
THE PAIN CLINIC OF MISSISSIPPI, PLLC
Nurse Practitioner (Family)
5903 RIDGEWOOD RD, SUITE 440
JACKSON, MS 39211
Hinds County (601) 899-3989
GENEVIEVE CELESTE GARRETT LCSW, MPH, CHES
Social Worker (Clinical)
5903 RIDGEWOOD RD
JACKSON, MS 39211
Hinds County (601) 984-2955
LESLIE ROOKS R.N.F.A.
Registered Nurse (Registered Nurse First Assistant)
5903 RIDGEWOOD RD
JACKSON, MS 39211
Hinds County (601) 982-8121
SELECT SPECIALTY HOSPITAL - JACKSON INC
Long Term Care Hospital
5903 RIDGEWOOD RD
JACKSON, MS 39211
Hinds County (601) 376-1099
MEDICAL CARE ALLIANCE LLC
Clinic/Center (Health Service)
5903 RIDGEWOOD RD, SUITE 310
JACKSON, MS 39211
Hinds County (601) 899-3320
DR. BABATUNDE OLUTADE MD
Internal Medicine (Nephrology)
5903 RIDGEWOOD RD, SUITE 340
JACKSON, MS 39211
Hinds County (601) 899-3340

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 Diversified Renal Group LLC's NPI number?

The NPI number for Diversified Renal Group LLC is 1184792038. It was assigned to this organization in the NPPES registry on November 30, 2006.

Where is Diversified Renal Group LLC located?

Diversified Renal Group LLC is located at 5903 Ridgewood Rd Ste 340, Jackson, MS 39211. The listed phone number is (601) 899-3340.

What is Diversified Renal Group LLC's specialty?

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

What insurance does Diversified Renal Group 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 Diversified Renal Group 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 Diversified Renal Group LLC was last updated on April 25, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.