Diversified Renal Group LLC
NPI 1184792038 · Nephrology Physician · Jackson, MS
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Diversified Renal Group LLC is a Nephrology Physician organization in Jackson, MS (NPI 1184792038).
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
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
Mailing address
Registry dates
- Enumerated
- 2006-11-30
- Last updated
- 2008-04-25
Frequently asked questions
- What is Diversified Renal Group LLC's NPI number?
- Diversified Renal Group LLC's National Provider Identifier (NPI) is 1184792038, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Diversified Renal Group LLC?
- Diversified Renal Group LLC is classified in the NPPES registry as Nephrology Physician (Allopathic & Osteopathic Physicians).
- Where is Diversified Renal Group LLC located?
- Diversified Renal Group LLC's practice location on file with NPPES is 5903 Ridgewood Rd, Jackson, MS 39211.
- What is Diversified Renal Group LLC's phone number?
- The practice phone number listed in the NPPES registry for Diversified Renal Group LLC is (601) 899-3340.
- Does Diversified Renal Group LLC accept Medicare?
- Diversified Renal Group LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Diversified Renal Group LLC?
- The authorized official listed on Diversified Renal Group LLC's NPPES record is Gary Davis, Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Diversified Renal Group LLC's NPI active?
- Yes — Diversified Renal Group LLC's NPI (1184792038) is active in the NPPES registry as of the last update on 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.