Usrc SW Ft Worth LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

008443 Issued in TX

Legal business name

USRC SW FT WORTH LLC

Practice address

5127 Old Granbury Rd
Fort Worth, TX 76133-2017

Phone

(817) 370-7830

Fax

(817) 370-1927

NPI assigned

May 25, 2006

Organization subpart

Yes

Parent organization

US RENAL CARE INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Thomas L Weinberg

Title

Vice-President and General Counsel

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 2

• U.S. Renal Care Southwest Fort Worth Dialysis Doing business as
• U.S. Renal Care Tarrant Dialysis Southwest Fort Worth Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Usrc Southwest Fort WorthCCN 672559

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Feb 12, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

24

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

US Renal Care Inc

Locations

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Michael Babigumira, MD

  • Nephrology Physician
  • Fort Worth, TX
  • NPI 1487068326

  Dialysis facility

  Care Compare affiliation Name & address match
• Prejith P Rajendran, M.D.

  • Nephrology Physician
  • North Richland Hills, TX
  • NPI 1255758298

  Dialysis facility

  Care Compare affiliation Name & address match
• Avinash Vallurupalli, DO

  • Nephrology Physician
  • Fort Worth, TX
  • NPI 1457553224

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1023064623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251549",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251500",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5127 OLD GRANBURY RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761332017",
            "telephone_number": "817-370-7830",
            "fax_number": "817-370-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC SW FT WORTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE INC",
        "enumeration_date": "2006-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE-PRESIDENT AND GENERAL COUNSEL",
        "authorized_official_telephone_number": "214-736-2700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "008443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Southwest Fort Worth Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "U.S. Renal Care Tarrant Dialysis Southwest Fort Worth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.