Diversified Renal Group LLC
Diversified Renal Group LLC is a healthcare organization registered as Nephrology Physician in Jackson, MS, holding Type 2 (organization) NPI 1184792038 since 2006. The authorized official on file is Gary Davis, Member.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1184792038 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Diversified Renal Group LLC |
| Practice address | 5903 RIDGEWOOD RD, STE 340, Jackson, MS, 39211 |
| Phone | 6018993340 |
| Fax | 6018993343 |
| Enumeration date | 2006-11-30 |
| Last updated in NPPES | 2008-04-25 |
Authorized official
| Name | Gary Davis |
|---|---|
| Title | Member |
| Phone | 6018993340 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207RN0300X | Nephrology Physician | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09014813 | Medicaid | MS | — |
Copy-ready billing details
Provider: Diversified Renal Group LLC NPI: 1184792038 Taxonomy: 207RN0300X (Nephrology Physician) Address: 5903 RIDGEWOOD RD, STE 340, Jackson, MS, 39211
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1255330163 | Select Specialty Hospital - Jackson Inc | Organization | Long Term Care Hospital | Jackson, MS |
| 1811901242 | Reddix Family Clinic PA | Organization | Internal Medicine Physician | Jackson, MS |
| 1316050750 | Babatunde Olutade | Individual | Nephrology Physician | Jackson, MS |
| 1629177415 | Anthony V. Parkinson, D.C., LLC | Organization | Chiropractor | Jackson, MS |
| 1760576102 | Anthony Parkinson | Individual | Chiropractor | Jackson, MS |
| 1760561252 | James Moore | Individual | Nephrology Physician | Jackson, MS |
| 1912065251 | Gary Davis | Individual | Nephrology Physician | Jackson, MS |
| 1982818282 | Joe G. Collins, D.D.S., P.A. | Organization | Endodontics | Jackson, MS |
Verify this record
Cross-check NPI 1184792038 against the authoritative CMS record: view Diversified Renal Group LLC on the official NPPES registry .
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 or validate an NPI number.
Frequently asked questions
Where is Diversified Renal Group LLC located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2008-04-25.