Jacksonville Kidney Center LLC
NPI 1255647491 · Nephrology Physician · Jacksonville, FL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jacksonville Kidney Center LLC is a Nephrology Physician organization in Jacksonville, FL (NPI 1255647491).
Provider details
- NPI number
- 1255647491
- Entity type
- Organization
- Primary specialty
- Nephrology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Koteswari Kancha, President(904) 647-8207
- License
- ME 98954 (FL)
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
15 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
- 2010-08-25
- Last updated
- 2016-12-08
Frequently asked questions
- What is Jacksonville Kidney Center LLC's NPI number?
- Jacksonville Kidney Center LLC's National Provider Identifier (NPI) is 1255647491, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jacksonville Kidney Center LLC?
- Jacksonville Kidney Center LLC is classified in the NPPES registry as Nephrology Physician (Allopathic & Osteopathic Physicians).
- Where is Jacksonville Kidney Center LLC located?
- Jacksonville Kidney Center LLC's practice location on file with NPPES is 13241 Bartram Park Blvd Unit 409, Jacksonville, FL 32258-5237.
- What is Jacksonville Kidney Center LLC's phone number?
- The practice phone number listed in the NPPES registry for Jacksonville Kidney Center LLC is (904) 400-6800.
- Does Jacksonville Kidney Center LLC accept Medicare?
- Jacksonville Kidney Center 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 Jacksonville Kidney Center LLC?
- The authorized official listed on Jacksonville Kidney Center LLC's NPPES record is Koteswari Kancha, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jacksonville Kidney Center LLC's NPI active?
- Yes — Jacksonville Kidney Center LLC's NPI (1255647491) is active in the NPPES registry as of the last update on 2016-12-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.