THE KIDNEY CARE CENTER, LLC (NPI# 1518233212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518233212 |
| Entity Type | Organization |
| Organization Name | THE KIDNEY CARE CENTER, LLC |
| Practice Address |
1126 Slide Rd Suite 4b Lubbock TX 79416-5402 |
| Practice Telephone | 8067710906 |
| Practice Fax Number | 8067710896 |
| Mailing Telephone | 8067710906 |
| Mailing Fax Number | 8067710896 |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2019-12-13 |
| Authorized Official Name | CLARENCE J. WHEELER III (PRESIDENT) |
| Authorized Official Telephone | 8067938447 |
| Authorized Official Credential | M.D. |
| 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 |
F7299 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | CMS CERTIFICATION NUMBER (CCN) | 672714 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801420864 | The Kidney Care Center, LLC | Clinic/Center | 3702 Interstate 27, Lubbock, TX 79412 | 2020-02-28 |
| 1043610819 | The Kidney Care Center, LLC | Clinic/Center | 3921 N. Calle Grande, Hobbs, NM 88240-0954 | 2014-08-29 |
| Street Address |
1126 SLIDE RD SUITE 4B |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79416-5402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699776732 | Clarence Joseph Wheeler IIi | Specialist | 1126 Slide Rd, 4b, Lubbock, TX 79416-5402 | 2005-08-10 |
| 1669909404 | Lubbock Interventional Nephrology Associates | Clinic/Center | 1126 Slide Rd, Suite # 1, Lubbock, TX 79416-5462 | 2017-05-11 |
| 1992248512 | Lubbock Vascular Access Center | Clinic/Center | 1126 Slide Rd, Suite 1, Lubbock, TX 79416-5462 | 2016-11-30 |
| 1700018991 | Yvette Corinne Tomacruz | Internal Medicine | 1126 Slide Rd, Suite 4-b, Lubbock, TX 79416-5402 | 2009-08-20 |
| 1154545036 | Lubbock Kidney and Blood Pressure Clinic Pa | Durable Medical Equipment & Medical Supplies | 1126 Slide Rd, Suite 4-b, Lubbock, TX 79416-5402 | 2007-04-12 |
| 1316958663 | Lubbock Kidney & Blood Pressure Clinic P A | Internal Medicine | 1126 Slide Rd, Suite 4b, Lubbock, TX 79416-5402 | 2006-08-11 |
| 1447280664 | Southwest Medical Supply Co Inc. | Clinic/Center | 1126 Slide Rd, Suite 4b, Lubbock, TX 79416-5402 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710502174 | Jordan Lane Thompson | Pharmacist | 6313 4th Street, Lubbock, TX 79416 | 2020-06-11 |
| 1821636481 | Chieh-an Chou | Specialist/Technologist | 201 N Winston Ave, Lubbock, TX 79416 | 2019-12-13 |
| 1790341949 | Michael Mcpherson, M.d. P.a. | Internal Medicine | 5406 Colgate St, Lubbock, TX 79416 | 2019-05-14 |
| 1154893675 | South Plains Rehabilitation Hospital, LLC | Rehabilitation Hospital | 5406 Colgate Street, Lubbock, TX 79416 | 2018-12-21 |
| 1932697182 | Timothy Sampana | Student in an Organized Health Care Education/Training Program | 5217 Lehigh St, Lubbock, TX 79416 | 2018-04-24 |
| 1306347711 | 4th Street Dental, Pllc | Dentist | 5709 4th St, Lubbock, TX 79416 | 2018-02-22 |
| 1639682503 | South Plains Surgery Center LLC | Clinic/Center | 4412 6th Street, Lubbock, TX 79416 | 2017-11-14 |
| 1013459809 | Isabel Garcia | Occupational Therapy Assistant | 1717 Northfolk Ave, #a, Lubbock, TX 79416 | 2016-11-09 |
| 1033589213 | Rehab Care | Skilled Nursing Facility | 1717 Norfork Ave, Bldg A, Lubbock, TX 79416 | 2015-10-01 |
| 1902281306 | Carrillon | Clinic/Center | 1717 Norfold Bld A, Lubbock, TX 79416 | 2015-07-27 |
| Find all providers in zip 79416 | ||||
| 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 |
|---|---|---|---|---|
| 1801420864 | The Kidney Care Center, LLC | Clinic/Center | 3702 Interstate 27, Lubbock, TX 79412 | 2020-02-28 |
| 1235685470 | Bio-medical Applications of Texas, Inc. | Clinic/Center | 8704 University Ave, Lubbock, TX 79423-3174 | 2016-08-28 |
| 1033559497 | Fresenius Medical Care Lubbock, LLC | Clinic/Center | 2710 Avenue Q, Lubbock, TX 79411-2446 | 2013-07-01 |
| 1649372814 | Bio Medical Applications of Texas, Inc. | Clinic/Center | C/o Lubbock Area Office, 6630 Quaker Avenue, Suite 208, Lubbock, TX 79413 | 2006-09-01 |
| 1679685564 | Bio-medical Applications of Texas Inc | Clinic/Center | 1126 Slide Rd Unit 4a, Lubbock, TX 79416-5402 | 2006-08-31 |
| 1497867378 | Bio-medical Applications of Texas, Inc. | Clinic/Center | 6630 Quaker Ave Ste 102, Lubbock, TX 79413-5939 | 2006-08-31 |
| 1598310179 | Angelo Kidney Connection Home Therapies Pllc | Clinic/Center | 3626 50th St, Lubbock, TX 79413-3994 | 2019-08-09 |
| 1013306133 | Innovative Dialysis Center of Lubbock, LLC | Clinic/Center | 1826 Parkway Dr, Lubbock, TX 79403-4406 | 2015-01-13 |
| 1669711172 | Diablo Dialysis LLC | Clinic/Center | 1923 Marsha Sharp Fwy, #102, Lubbock, TX 79415-4036 | 2013-02-04 |
| 1922293703 | Rsa - South Plains, LLP | Clinic/Center | 3801 21st St, Lubbock, TX 79410-1006 | 2007-09-13 |
| Find all providers in LUBBOCK | ||||
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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.