OrganizationActive
Diversified Renal Group LLC
NPI 1184792038 · Nephrology Physician · Jackson, MS
Provider details
- NPI number
- 1184792038
- Entity type
- Organization
- Primary specialty
- Nephrology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Gary Davis, Member(601) 899-3340
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5903 Ridgewood Rd
Ste 340
Jackson, MS 39211
Phone: (601) 899-3340
Fax: (601) 899-3343
Street-level locationGet directions
Mailing address
Po Box 2057
Ridgeland, MS 39158
Registry dates
- Enumerated
- 2006-11-30
- Last updated
- 2008-04-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.