PROVO KIDNEY CARE LLC (NPI# 1972056893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972056893 |
| Entity Type | Organization |
| Organization Name | PROVO KIDNEY CARE LLC |
| Practice Address |
920 Winter St Waltham MA 02451-1521 |
| Practice Telephone | 4806397186 |
| Practice Fax Number | 6027988267 |
| Mailing Telephone | 4806397186 |
| Mailing Fax Number | 6027988267 |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-07-27 |
| Authorized Official Name | PAMELA VP (VICE PRESIDENT) |
| Authorized Official Telephone | 4806397186 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
001 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
920 WINTER ST |
| City | WALTHAM |
| State | MA |
| Zip Code | 02451-1521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144265323 | Fresenius Management Services, Inc. | Clinic/Center | 920 Winter St, Waltham, MA 02451-1521 | 2006-06-19 |
| 1528669728 | Azura Anesthesia Partners LLC | Anesthesiology | 920 Winter St, Waltham, MA 02451-1521 | 2020-11-04 |
| 1215542717 | Juliana Richardson | Nurse Practitioner | 920 Winter St, Waltham, MA 02451-1521 | 2020-09-10 |
| 1396298212 | Front Range Kidney Care Pllc | Internal Medicine | 920 Winter St, Waltham, MA 02451-1521 | 2016-07-27 |
| 1790137578 | Fresenius Medical Care | Preferred Provider Organization | 920 Winter St, Waltham, MA 02451-1521 | 2016-07-06 |
| 1104285121 | Fresenius Vascular Care, Inc | Radiology | 920 Winter St, Waltham, MA 02451-1521 | 2016-02-18 |
| 1003280066 | New Orleans Kidney Care LLC | Internal Medicine | 920 Winter St, Waltham, MA 02451-1521 | 2015-11-13 |
| 1144617820 | Albany Kidney Care LLC | Internal Medicine | 920 Winter St, Waltham, MA 02451-1521 | 2015-04-21 |
| 1376936351 | Dennis Dugan | Registered Nurse | 920 Winter St, Waltham, MA 02451-1521 | 2015-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719190 | Haeun Yang | Behavior Technician | 303 Wyman Street Suite 354, 344, 345, Waltham, MA 02451 | 2019-09-16 |
| 1982252599 | Sinclair Fashaw-braxton | Behavior Technician | 303 Wyman Street, Suite 354, 344, 345, Waltham, MA 02451 | 2019-08-27 |
| 1245715879 | Annie F Friedman | Social Worker | Extended Stay America, 32 4the Avenue, Waltham, MA 02451 | 2018-09-28 |
| 1760964118 | Elizabeth Boardman Harris | Social Worker | 60 Hickory Drive 4th Floor, Waltham, MA 02451 | 2018-09-02 |
| 1760960959 | Patriot Urgent Care Professionals, PC | General Practice | 1030 Main Street, Unit 2, Waltham, MA 02451 | 2018-07-31 |
| 1962998013 | Leighann Teresa Healy | Behavior Technician | 303 Wyman Suite 300, Waltham, MA 02451 | 2018-07-02 |
| 1194234492 | Bruna Rossi Hoffman | Dentist | 12 Grant Place, Apt 1, Waltham, MA 02451 | 2017-09-29 |
| 1265959159 | Matthew C Page-shelton | Counselor | 2208 Stearns Hill Road, Waltham, MA 02451 | 2017-08-23 |
| 1306380837 | Sherri Lynn Duquette | Behavior Technician | 1430 Main Street, Waltham, MA 02451 | 2016-12-19 |
| 1649628728 | Keren Matveev | Family Medicine | 75 Third Avenue, First Floor, Waltham, MA 02451 | 2016-05-30 |
| Find all providers in zip 02451 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831318971 | Burton D Rose | Internal Medicine | Up To Date, 95 Sawyer Road, Waltham, MA 02453-3471 | 2007-04-25 |
| 1396298212 | Front Range Kidney Care Pllc | Internal Medicine | 920 Winter St, Waltham, MA 02451-1521 | 2016-07-27 |
| 1003280066 | New Orleans Kidney Care LLC | Internal Medicine | 920 Winter St, Waltham, MA 02451-1521 | 2015-11-13 |
| 1952540940 | Andrew T Blair | Internal Medicine | 200 West St, Waltham, MA 02451-1121 | 2009-02-13 |
| 1457308140 | Mawya Shocair | Internal Medicine | 6 Lexington St, 2nd Floor, Waltham, MA 02452-4401 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386275444 | Grace Medical PC | Internal Medicine | 16 Ledge Hill St, Randolph, MA 02368-3514 | 2020-01-28 |
| 1588154041 | Ralph Nader | Internal Medicine | 72 East Concord St, Collamore Suite 29, Boston, MA 02118 | 2018-05-10 |
| 1184122905 | Claire Avillach | Internal Medicine | 650 Albany St Rm 540, Boston, MA 02118-2518 | 2018-01-26 |
| 1457880213 | Kidney Care and Transplant Services of New England, PC | Internal Medicine | 51 Locust St Ste 3, Northampton, MA 01060-2045 | 2017-06-06 |
| 1609263888 | Naveed Ashfaq | Internal Medicine | 148 Green St, Foxboro, MA 02035-2869 | 2015-04-24 |
| 1043612823 | New England Nephrology Associates, Pllc | Internal Medicine | 263 Huntington Ave # 232, Boston, MA 02115-4506 | 2014-09-23 |
| 1215345178 | Loulwa Alsharhan | Internal Medicine | 650 Albany St Fl 5, Boston, MA 02118-2518 | 2014-07-23 |
| 1154653921 | Innovative Medicine, PC | Internal Medicine | 70 Parker Hill Ave, Suite 3406, Roxbury Crossing, MA 02120-3224 | 2010-02-04 |
| 1639324791 | Patricia A Suzman | Internal Medicine | 87 Beacon St, Boston, MA 02108-3323 | 2008-11-17 |
| 1497922439 | Harald Sinclair Mackenzie | Internal Medicine | 422b Monument St, Concord, MA 01742-1810 | 2008-05-09 |
| Find all providers with the same taxonomy | ||||
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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.