MEDICARE: EVERGREEN NEPHROLOGY OF GOLDEN STATE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2084P0800X	Psychiatry Physician
2	363A00000X	Physician Assistant
3	213E00000X	Podiatrist
4	363L00000X	Nurse Practitioner
5	163W00000X	Registered Nurse
6	207R00000X	Internal Medicine Physician
7	164W00000X	Licensed Practical Nurse
8	164X00000X	Licensed Vocational Nurse
9	133V00000X	Registered Dietitian
10	183500000X	Pharmacist
11	104100000X	Social Worker
12	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1932800927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERGREEN NEPHROLOGY OF GOLDEN STATE PC

Provider Business Mailing Address
First Line	:	210 ATHENS WAY STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37228-1308
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 ATHENS WAY STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37228-1308
Country	:	US
Telephone Number	:	615-270-3505
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TIMOTHY A. PFLEDERER
Credential	:	MD
Telephone Number	:	309-696-0683

Provider Enumeration Date	:	03/15/2023
Last Update Date	:	02/10/2026

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