CVS-SHC KIDNEY CARE HOME DIALYSIS OF AUSTIN LLC (NPI# 1023639739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023639739 |
| Entity Type | Organization |
| Organization Name | CVS-SHC KIDNEY CARE HOME DIALYSIS OF AUSTIN LLC |
| Practice Address |
9811 S Interstate Highway 35 Ste 100 Austin TX 78744-7901 |
| Mailing Address |
300 Santana Row Ste 300 San Jose CA 95128-2424 |
| Practice Telephone | 5127356300 |
| Practice Fax Number | 5122921465 |
| Mailing Telephone | 6504043655 |
| Mailing Fax Number | 6506256007 |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2020-05-04 |
| Authorized Official Name | KARI HOLLOWAY (VP) |
| Authorized Official Telephone | 4042905964 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BUSINESS LICENSE | 110478 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Kidney Care Home Dialysis Satellite Healthcare WellBound | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063033520 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 10000 Metric Blvd Ste 100, Austin, TX 78758-5210 | 2020-05-06 |
| 1477174951 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 12176 N Mo Pac Expy Ste A, Austin, TX 78758-2908 | 2020-05-06 |
| 1770104481 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 10001 S Ih 35 Ste 100, Austin, TX 78747-1701 | 2020-05-04 |
| 1194346809 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 1801 E 51st St Ste 100, Austin, TX 78723-3444 | 2020-05-04 |
| 1467073171 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 16010 Park Valley Dr Ste 100, Round Rock, TX 78681-3575 | 2020-05-04 |
| 1720609431 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 1701 W Ben White Blvd Ste 180, Austin, TX 78704-7680 | 2020-05-04 |
| 1811518525 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 134 Elmhurst Drive, Kyle, TX 78640-6060 | 2020-05-04 |
| Street Address |
9811 S INTERSTATE HIGHWAY 35 STE 100 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78744-7901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013985 | Kyle Allan Mccall | Counselor | 5015 S Ih 35 Frontage Rd, Suite 200, Austin, TX 78744 | 2020-11-06 |
| 1285245753 | Michelle Susan Kuczkowski | Nurse Practitioner | 6230 E. Stassney Lane, Austin, TX 78744 | 2020-08-10 |
| 1497365704 | Kaushal Mansinhbhai Chaudhari | Dentist | 1612 E William Cannon Dr, Austin, TX 78744 | 2020-08-03 |
| 1124664933 | Andre Nettie Gardiner-martinez | Social Worker | 7701 Metropolis Drive, Bldg 13, Suite 100, Austin, TX 78744 | 2019-11-27 |
| 1699259192 | Kedra S Priest | Counselor | 5015 Sih 35, Austin, TX 78744 | 2018-09-20 |
| 1720568512 | Melissa Jonfe-quinto | Speech-Language Pathologist | 8300 Bluff Springs Road, Apt 616, Austin, TX 78744 | 2018-08-21 |
| 1255821195 | Samantha Padilla | Nurse Practitioner | 7701 Metropolis Dr., Austin, TN 78744 | 2018-05-16 |
| 1275050544 | Ann-marie Keller | Student in an Organized Health Care Education/Training Program | 7900 Ardmore Circle, Austin, TX 78744 | 2017-08-27 |
| 1477944171 | Lindsay Box | Counselor | 5015 S Ih-35 Frontage Rd, #200, Austin, TX 78744 | 2015-02-17 |
| 1487050308 | William Alexander Terry | Social Worker | 5015 S Ih 35 Frontage Rd #200, Austin, TX 78744 | 2014-11-05 |
| Find all providers in zip 78744 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063033520 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 10000 Metric Blvd Ste 100, Austin, TX 78758-5210 | 2020-05-06 |
| 1477174951 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 12176 N Mo Pac Expy Ste A, Austin, TX 78758-2908 | 2020-05-06 |
| 1770104481 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 10001 S Ih 35 Ste 100, Austin, TX 78747-1701 | 2020-05-04 |
| 1194346809 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 1801 E 51st St Ste 100, Austin, TX 78723-3444 | 2020-05-04 |
| 1720609431 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 1701 W Ben White Blvd Ste 180, Austin, TX 78704-7680 | 2020-05-04 |
| 1538791298 | Renal Treatment Centers - Southeast, Lp | Clinic/Center | 7912 Cameron Rd, Austin, TX 78754-3826 | 2020-02-10 |
| 1992346316 | Cdi Health, LLC | Clinic/Center | 1717 W 6th St Ste 350, Austin, TX 78703-4870 | 2019-10-07 |
| 1376100818 | Nicona Dialysis LLC | Clinic/Center | 9010 Brodie Lane, Bldg A, Austin, TX 78748-5184 | 2019-05-21 |
| 1013357110 | Satellite Wellbound of South Austin, LLC | Clinic/Center | 9811 S Ih 35, Bldg 4 Suite 200, Austin, TX 78744 | 2013-07-03 |
| 1518234525 | Renal Treatment Centers Southeast Lp | Clinic/Center | 3601 Manor Rd, Austin, TX 78723-5816 | 2011-11-18 |
| Find all providers in AUSTIN | ||||
Please comment or provide details below to improve the information on CVS-SHC KIDNEY CARE HOME DIALYSIS OF AUSTIN LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.