The Kidney Care Center, LLC

Primary specialty

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

Legal business name

THE KIDNEY CARE CENTER, LLC

Doing business as

The Kidney Care Center - Hobbs

Practice address

3921 N. Calle Grande
Hobbs, NM 88240-0954

Phone

(575) 738-0400

Fax

(575) 738-0402

NPI assigned

Aug 29, 2014

Last updated

Aug 16, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

THE KIDNEY CARE CENTER, LLCAs reported in NPPES

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

Authorized official

Name

Shontal Carruth

Title

Billing Manager

Phone

(806) 771-0906

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Kidney Care Center - Hobbs Doing business as

Medicare fee-for-service enrollment

Enrolled in NM2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• The Kidney Care Center, LLC

  dba The Kidney Care Center, LLC - Lubbock

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lubbock, TX
  • NPI 1801420864

  0648423533

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Lubbock Kidney & Blood Pressure Clinic P a

  • Nephrology Physician
  • Lubbock, TX
  • NPI 1316958663

  O20070509000307

  Same enrollment

Listed as

322547-Kidney Care Center-HobbsCCN 322547

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Feb 9, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Other

Dialysis stations

17

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

CLIA laboratory certificates

Tax ID family

The Kidney Care Center LLC2 organizations share this tax ID, including this one

Part of

The Kidney Care Center LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Kidney Care Center, LLC

  dba The Kidney Care Center, LLC - Lubbock

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lubbock, TX
  • NPI 1801420864
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• The Kidney Care Center, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lubbock, TX
  • NPI 1518233212

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mustafa Aly, MD

  • Internal Medicine Physician
  • Lubbock, TX
  • NPI 1003195256
  NPD
• Jennifer Lee Coleman, FNP

  • Family Nurse Practitioner
  • Lubbock, TX
  • NPI 1548349467
  NPD
• Ruben Dario Villa, M.D.

  • Nephrology Physician
  • Lubbock, TX
  • NPI 1659367647
  NPD

Affiliated clinicians 1

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

• Nayankumar Amrutbhai Patel, MD

  • Nephrology Physician
  • Lubbock, TX
  • NPI 1972796985

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1043610819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 SLIDE RD",
            "address_2": "SUITE 4B",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794165402",
            "telephone_number": "806-771-0906",
            "fax_number": "806-771-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 N. CALLE GRANDE",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882400954",
            "telephone_number": "575-738-0400",
            "fax_number": "575-738-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KIDNEY CARE CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE KIDNEY CARE CENTER, LLC",
        "enumeration_date": "2014-08-29",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "CARRUTH",
        "authorized_official_first_name": "SHONTAL",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "806-771-0906"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO DEPARTMENT OF  HEALTH",
            "identifier": "3538",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Kidney Care Center - Hobbs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aemon Rowan Techeira, MD
• Deanna Teel, DPT
• Christine Templeton
• Manuel Tersero
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Hobbs Village)
• The Orthopaedics Center LLC
• Therapy Plus, Inc.
• Therapy Services Associates, Professional Corp
• Candice Nicole Thomas, FNP-C
• Chantelle Thomas

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Hobbs, NM
• Providers in Hobbs, NM by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.