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General NPI Number Information
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NPI Number | 1801597869
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Entity Type | Organization
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Legal Business Name | EVERGREEN NEPHROLOGY OF THE MIDWEST, PLLC
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Dates
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Enumeration Date | 03/15/2023
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 210 ATHENS WAY STE 200
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City | NASHVILLE
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State | TN
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Zip | 37228-1308
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Country | US
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Telephone | 615-270-3505
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Fax |
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Provider Business Mailing Address
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Address Line | 210 ATHENS WAY STE 200
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City | NASHVILLE
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State | TN
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Zip | 37228-1308
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY PFLEDERER
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Credential | MD
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Telephone | 615-270-3505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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