VILLANUEVA DIALYSIS LLC (NPI# 1477836039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477836039 |
| Entity Type | Organization |
| Organization Name | VILLANUEVA DIALYSIS LLC |
| Other Organization Name | MOJAVE SAGE DIALYSIS |
| Practice Address |
17207 Jasmine St Victorville CA 92395-7786 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 7602418167 |
| Practice Fax Number | 7608435685 |
| Mailing Telephone | 6153416765 |
| Mailing Fax Number | 8337829089 |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2019-03-07 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334500 |
| 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 |
550001904 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1477836039 | 05 |
| Other Name | Type Code |
|---|---|
| Mojave Sage Dialysis | Doing Business As Name - Organization |
| Street Address |
17207 JASMINE ST |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92395-7786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235127515 | Edgard Mario Vera Tapia | Internal Medicine | 17207 Jasmine St, 2, Victorville, CA 92395 | 2005-10-11 |
| 1871734921 | Edgard M. Vera, Md,inc. | Internal Medicine | 17207 Jasmine St, 2, Victorville, CA 92395 | 2009-03-19 |
| 1992891956 | Sheila Cherian | Internal Medicine | 17207 Jasmine St, 2, Victorville, CA 92395 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1376179093 | Catherine Ward | Speech-Language Pathologist | 13275 Mauka Ct, Victorville, CA 92395 | 2020-03-13 |
| 1174019228 | Laura Mercado Halterman | Family Medicine | 16519 Victor St Ste 307, Victorville, CA 92395 | 2018-07-02 |
| 1306337829 | Stephanie Ann Kruger | Behavior Technician | Sunny Days Inc 3602 Inland Empire Blvd., Ontario, CA 92395 | 2018-05-21 |
| 1861903924 | Debra L Andersen | Clinic/Center | 12830 Hesperia Road, Suite C, D, E, Victorville, CALIFORNIA 92395 | 2017-10-17 |
| 1790202141 | Joshua Powers | Physician Assistant | 12550 Hesperia Rd Ste 101, Victorville, CA 92395 | 2017-08-26 |
| 1043759491 | Kemp Individual & Family Therapy, Inc. | Marriage & Family Therapist | 14075 Hesperia Road, Suite 101, Victorville, CA 92395 | 2017-02-17 |
| 1740725969 | Abem Transportation Inc | Non-emergency Medical Transport (VAN) | 15000 7th St Ste F208, Victorville, CA 92395 | 2016-12-23 |
| 1447669379 | Tracie Girard | Nurse Practitioner | 17330 Bear Valley Road, Suite A106, Victorville, CA 92395 | 2014-08-05 |
| 1093153215 | Mitesh Patel | Surgery | 13010 Hesperia Rd Ste 400, Victorville, CA 92395 | 2013-06-10 |
| Find all providers in zip 92395 | ||||
| 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 |
|---|---|---|---|---|
| 1588202378 | Dsi Apple Valley Home Dialysis, LLC | Clinic/Center | 17125 Silica Dr Ste 100, Victorville, CA 92395-7715 | 2019-12-12 |
| 1073960845 | Dsi Apple Valley Home Dialysis, LLC | Clinic/Center | 17125 Silica Dr Ste 102, Victorville, CA 92395-7715 | 2016-05-20 |
| 1447615869 | Rollins Dialysis LLC | Clinic/Center | 15002 Amargosa Rd, Victorville, CA 92394-1868 | 2015-12-30 |
| 1225460264 | Jamboor Medical Corporation | Clinic/Center | 11883 Amethyst Rd, Victorville, CA 92392-9224 | 2013-08-01 |
| 1063421212 | Jamboor Medical Corporation | Clinic/Center | 12675 Hesperia Rd, Victorville, CA 92395-5878 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444765 | Kinter Dialysis, LLC | Clinic/Center | 1055 El Camino Real, Colma, CA 94014-3234 | 2020-10-16 |
| 1063010734 | Monad Dialysis, LLC | Clinic/Center | 5238 Manzanita Ave, Carmichael, CA 95608-0510 | 2020-10-14 |
| 1891305462 | Auberry's Home Hemo Dialysis | Clinic/Center | 8200 S Normandie Ave, Los Angeles, CA 90044-2336 | 2020-08-07 |
| 1376152645 | Navin Dialysis, LLC | Clinic/Center | 4314 E Jensen Ave, Fresno, CA 93706-9049 | 2020-07-23 |
| 1669080107 | Total Renal Care Inc | Clinic/Center | 4270 Rosewood Dr Ste E, Pleasanton, CA 94588-3065 | 2020-07-21 |
| 1659997112 | Arbela Dialysis LLC | Clinic/Center | 900 Huntington Dr Ste B, San Marino, CA 91108-1825 | 2020-06-22 |
| 1275158487 | Cudahy Peritoneal Dialysis Center | Clinic/Center | 4566 Florence Ave Ste 3, Cudahy, CA 90201-4346 | 2020-06-12 |
| 1659994903 | Bio Medical Applications of California Inc | Clinic/Center | 1287 N Hacienda Blvd, La Puente, CA 91744-1631 | 2020-05-21 |
| 1245853654 | Culbert Dialysis LLC | Clinic/Center | 4223 E Anaheim St, Long Beach, CA 90804-4202 | 2020-05-20 |
| 1790308179 | Palo Dialysis LLC | Clinic/Center | 10211 Long Beach Road, Lynwood, CA 90262-1508 | 2020-05-20 |
| Find all providers with the same taxonomy | ||||
| City | VICTORVILLE |
| Zip Code | 92395 |
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| 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.