NPIMap

Organization Active NPI

Memorial Hermann Health System

Doing business as Children's Memorial Hermann Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Houston, TX
National Provider Identifier
1063448124
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
00347 Issued in TX
Legal business name
MEMORIAL HERMANN HEALTH SYSTEM
Doing business as
Children's Memorial Hermann Dialysis Center
Practice address
6411 Fannin St
Houston, TX 77030-1501
Phone
(713) 704-6614
Fax
(713) 704-4798
NPI assigned
Jun 23, 2006
Last updated
Jun 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Authorized official

Name
Mr. Dennis Laraway
Title
Cfo
Phone
(713) 242-2707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 00347 TX Primary

Addresses

Primary practice location

6411 Fannin St
Houston, TX 77030-1501

Mailing address

PO Box 301208
Dallas, TX 75303-1208
Phone (713) 338-4127

Other identifiers 1

IdentifierTypeStateIssuer
137805112MedicaidTX

Other names 1

  • Children's Memorial Hermann Dialysis Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030716000015 TX Part A Provider - End-Stage Renal Disease Facility (ESRD) 1759292683 Practice locations: Houston, TX

Other NPIs with the same Medicare PAC ID 12

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Children's Memorial Hermann Dialysis CenterCCN 452309
Ownership
Non-profit
Certified
Apr 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Memorial Hermann Healthcare System
Dialysis stations
7

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Geriatric Resource CNTR66 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Ownership & related parties

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Memorial Hermann Sugar Land HospitalSugar Land, TX, CCN 450848 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control (100%)		 Jan 1, 2013
Jan 1, 2013
Memorial Hermann Katy HospitalKaty, TX, CCN 450847 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2001
Jul 1, 2001
Memorial Hermann Northeast HospitalHumble, TX, CCN 450684 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2007
Jan 1, 2007
Memorial Hermann Memorial City Medical CenterHouston, TX, CCN 450610 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2010
Jan 1, 2013
Memorial Hermann Texas Medical CenterHouston, TX, CCN 450068 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2013
Jan 1, 2013
Memorial Hermann Texas Medical Center Rehabilitation UnitHouston, TX, CCN 45T068 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2013
Jan 1, 2013
Memorial Hermann Hospital SystemHouston, TX, CCN 450184 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2013
Jan 1, 2013
Memorial Hermann Hospital System Rehabilitation UnitHouston, TX, CCN 45T184 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control (100%)		 Jan 1, 2013
Jan 1, 2013
Memorial Hermann Rehabilitation Hospital KatyKaty, TX, CCN 673038 Hospital 5% Or Greater Indirect Ownership Interest Apr 1, 2009
Tirr Memorial HermannHouston, TX, CCN 453025 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2013
Jan 1, 2013
Accentcare Home Health of Houston - North, LLCHouston, TX, CCN 457741 Home health agency 5% Or Greater Indirect Ownership Interest (40%) Apr 1, 2023
Accentcare Home Health of Houston - South, LLCSugar Land, TX, CCN 679102 Home health agency 5% Or Greater Indirect Ownership Interest (40%) Apr 1, 2023
Accentcare Hospice & Palliative Care of Houston - South, LLCHouston, TX, CCN 671559 Hospice 5% Or Greater Indirect Ownership Interest (40%) Apr 1, 2023
Accentcare Hospice & Palliative Care of Houston - North, LLCHouston, TX, CCN 671741 Hospice 5% Or Greater Indirect Ownership Interest (40%) Apr 1, 2023

Owned or controlled facilities with NPI records 27

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1063448124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 301208",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753031208",
            "telephone_number": "713-338-4127",
            "fax_number": "713-338-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-704-6614",
            "fax_number": "713-704-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HERMANN HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "LARAWAY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "713-242-2707",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "00347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137805112",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Memorial Hermann Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.