Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Diversified Renal Group LLC

Nephrology Physician in Jackson, MS · enumerated 2006 · authorized official Gary Davis, Member.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1184792038

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Registry record

Entity type Organization (Type 2)

Legal business name Diversified Renal Group LLC

Practice address 5903 Ridgewood Rd, Ste 340, Jackson, MS, 39211

Phone (601) 899-3340

Fax (601) 899-3343

Enumeration date Nov 30, 2006

Last updated in NPPES Apr 25, 2008

Taxonomy & classification

207RN0300X Nephrology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Gary Davis

Title Member

Phone (601) 899-3340

Other identifiers

Identifier	Type	State	Issuer
09014813	Medicaid	MS	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where is Diversified Renal Group LLC located?

The practice location on file with NPPES is in Jackson, MS.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2008-04-25. Verify at npiregistry.cms.hhs.gov.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-04-25.