KIDNEY AND HYPERTENSION CARE MID-AMERICA LLC – NPI #1114783859
Internal Medicine

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

KIDNEY AND HYPERTENSION CARE MID-AMERICA LLC is a provider located in JERSEYVILLE, IL. NPPES has assigned the NPI number 1114783859 to KIDNEY AND HYPERTENSION CARE MID-AMERICA LLC on February 21, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207RN0300X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Nephrology

The NPI profile was last updated on Oct 21, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KIDNEY AND HYPERTENSION CARE MID-AMERICA LLC below.

NPI Profile for
KIDNEY AND HYPERTENSION CARE MID-AMERICA LLC

NPI Number
1114783859
Enumeration Date

(more than 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
KIDNEY AND HYPERTENSION CARE MID-AMERICA LLC
Primary location
400 MAPLE SUMMIT RD
JERSEYVILLE, IL 62052-2028
Phone: (314) 628-7750 Fax:
Mailing address
PO BOX 289
CHESTERFIELD, MO 63006-0289
Phone: (314) 628-7750 Fax:
Organization Subpart
No
Authorized Official
MEHER MALLICK
OWNER
Phone: (314) 628-7750
Updated
Certification Date
Oct 21, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for KIDNEY AND HYPERTENSION CARE MID-AMERICA LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidIL03609903
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RN0300X
- Internal Medicine / Nephrology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.