Waxld LLC

Primary specialty

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

Legal business name

WAXLD LLC

Practice address

1011 N Highway 77
Ste 102
Waxahachie, TX 75165-1798

Phone

(972) 351-8575

NPI assigned

Jul 30, 2010

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Chairman & President

Phone

(214) 736-2730

Specialties & licenses 1

Addresses

Other names 2

• Liberty Dialysis - Waxahachie Doing business as
• Premier Dialysis - Waxahachie Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Usrc Premier WaxahachieCCN 672668

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Jun 21, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

13

Part of

US Renal Care Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• U.S. Renal Care, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Plano, TX
  • NPI 1588581870
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Srividya Venkataraman, MD

  • Nephrology Physician
  • Desoto, TX
  • NPI 1871684928
  NPD (past)

Affiliated clinicians 2

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

• Deepa Amberker, M.D.

  • Nephrology Physician
  • Dallas, TX
  • NPI 1154685592

  Dialysis facility

  Care Compare affiliation Name & address match
• Mahboob Ali Khan, MD

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1508834599

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1280448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1033423173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844631",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844631",
            "telephone_number": "214-736-2700",
            "fax_number": "214-736-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N HIGHWAY 77",
            "address_2": "STE 102",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651798",
            "telephone_number": "972-351-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAXLD LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2010-07-30",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHAIRMAN & PRESIDENT",
        "authorized_official_telephone_number": "214-736-2730"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Dialysis - Waxahachie",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Dialysis - Waxahachie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Amanda Deanne Weatherford
• David Lewis Webb, MD
• Andrea Fowler Weisbruch, FNP
• Meagan Patience Wells, MA, LPC-ASSOCIATE
• Irene Arlette Werthmann, LCSW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Waxahachie, TX
• Providers in Waxahachie, 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 Jul 24, 2023; 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.