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CRISP MEDICAL AND KIDNEY CARE LLC
NPI 1407606379
Internal Medicine in Cordele, GA

Active since March 25, 2024CLIA 11D2327032 · Waiver
401 E 4TH AVE, CORDELE, GA 31015(478) 953-0024(478) 953-0675 Get Directions Write a Review

NPPES record last updated: March 25, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Crisp Medical And Kidney Care Llc NPPES

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

CRISP MEDICAL AND KIDNEY CARE LLC (NPI 1407606379) is a healthcare organization registered as an internal medicine in Cordele, Georgia and active in the NPI registry since March 2024. The organization holds a CLIA Waiver certificate valid through July 14, 2027 and lists Srilatha Nadipineni, Md Owner, as its authorized official.

NPPES Registry Identity

NPI1407606379
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCRISP MEDICAL AND KIDNEY CARE LLC
Location Address401 E 4TH AVECordele, GA 31015-3620
Mailing Address401 E 4th AveCordele, GA 31015-3620 · (478) 953-0024 · Fax (478) 953-0675
Phone(478) 953-0024
Fax(478) 953-0675
Organization SubpartNo
Authorized OfficialSrilatha NadipineniMd Owner · (478) 953-0024
Enumeration DateMarch 25, 2024
NPPES CertifiedMarch 25, 2024
✔ NPI 1407606379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X
401 E 4TH AVE, Cordele, GA 31015
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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crisp Medical And Kidney Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Crisp Medical And Kidney Care LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Geraldine Jones, NP-C
Nurse Practitioner
NPI 1770899262
401 E 4TH AVE
Cordele, GA 31015
(229) 271-2180
✔ PECOS✔ Accepts MedicareSame address
Srilatha Nadipineni, MD
Internal Medicine
NPI 1073720496
110 E 4TH AVE
Cordele, GA 31015
(229) 276-2180
✔ PECOS✔ Accepts Medicare0.4 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2327032

Crisp Medical And Kidney Care LLC · Cordele, GA
Active · expires Jul 14, 2027
CLIA Number11D2327032
Laboratory TypePhysician Office
Certificate Effective DateJuly 15, 2025
Certificate Expiration DateJuly 14, 2027
Laboratory DirectorSrilatha Nadipineni
Laboratory Phone(229) 276-2180
Laboratory LocationCrisp Medical And Kidney Care LLC401 E 4th Avenue, Cordele, GA 31015
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Crisp Medical And Kidney Care LLC's NPI number?

The NPI number for Crisp Medical And Kidney Care LLC is 1407606379. It was assigned to this organization in the NPPES registry on March 25, 2024.

Where is Crisp Medical And Kidney Care LLC located?

Crisp Medical And Kidney Care LLC is located at 401 E 4th Ave, Cordele, GA 31015. The listed phone number is (478) 953-0024.

What is Crisp Medical And Kidney Care LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Crisp Medical And Kidney Care LLC enrolled in Medicare?

Yes. Crisp Medical And Kidney Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Crisp Medical And Kidney Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Crisp Medical And Kidney Care LLC, in Internal Medicine and Nurse Practitioner. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Crisp Medical And Kidney Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2327032) is associated with this NPI, valid through July 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Crisp Medical And Kidney Care LLC was last updated on March 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.