Pine Bluff Dialysis Inc

Primary specialty

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

Legal business name

PINE BLUFF DIALYSIS INC

Practice address

2800 W 28TH Ave
Pine Bluff, AR 71603-4921

Phone

(870) 534-7400

NPI assigned

Dec 30, 2005

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

Chairman

Phone

(214) 736-2730

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Pine Bluff - US Renal Care Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Listed as

Usrc Pine BluffCCN 042564

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Sep 27, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

25

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 4

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

• James Arthur Campbell Jr., M.D.

  • Nephrology Physician
  • Pine Bluff, AR
  • NPI 1689789984

  Dialysis facility

  Care Compare affiliation Name & address match
• Muhammad Ahmer Kashif, M.D.

  • Nephrology Physician
  • Pine Bluff, AR
  • NPI 1194719203

  Dialysis facility

  Care Compare affiliation Name & address match
• Syed Sheheryar Ahmed Shah, MD

  • Nephrology Physician
  • Pine Bluff, AR
  • NPI 1174019905

  Dialysis facility

  Care Compare affiliation Name & address match
• Brandi Pauline Wright, M.D.

  • Nephrology Physician
  • Pine Bluff, AR
  • NPI 1073889408

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1073590923",
    "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": "2800 W 28TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034921",
            "telephone_number": "870-534-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2302 W 28th Ave",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716035081",
            "country_code": "US",
            "telephone_number": "870-534-7400",
            "fax_number": "870-541-0845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PINE BLUFF DIALYSIS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE INC",
        "enumeration_date": "2005-12-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "214-736-2730",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145245734",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "12564",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Bluff - US Renal Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reid Guyton Pierce, M.D.
• Ruston Pierce, M.D.
• Pine Bluff Ar Opco LLC
• Pine Bluff Counseling Group, PLLC
• Pine Bluff Dental Center, PLLC
• Pine Bluff Endoscopy Center, LLC
• Pine Bluff Nursing, LLC
• Pine Bluff Pathologists PLLC
• Pine Bluff Radiologists, LTD
• Pine Bluff School District

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.